Section 3 – Data definitions · Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page iii . Functional Assessment Date on Separation (b) 96 ... Alpha/numeric

Department of Health

Section 3 – Data definitions Victorian Admitted Episodes Dataset (VAED) Manual, 21st edition, July 2011

Section 3 – Data definitions

Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page i

© Copyright, State of Victoria, Department of Health, 2011

Published by the Funding & Information Policy Branch, Victorian Government, Department of Health, Melbourne, Victoria. This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968.

This document is available in PDF format on the internet at: www.health.vic.gov.au/hdss/vaed/index.htm

Authorised by the State Government of Victoria, 50 Lonsdale Street, Melbourne.

Page ii Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011

http://www.health.vic.gov.au/hdss/vaed/index.htm

Contents

Introduction 1

Definitions 3 ACAS Status 3 Accommodation Type (a) 5 Accommodation Type on Separation (b) 5 Account Class (a) 9 Account Class on Separation (b) 9 Admission Date 19 Admission/Re-Admission to Rehabilitation 22 Admission Source 23 Admission Time 27 Admission Type 29 Admission Weight 33 Barthel Index Score on Admission (a) 35 Barthel Index Score on Separation (b) 35 Campus Code 38 Carer Availability 39 Care Type 42 Clinical Sub-Program 51 Contract Leave Days Financial Year-to-Date 54 Contract Leave Days Month-to-Date 56 Contract Leave Days Total 58 Contract Role 60 Contract/Spoke Identifier 62 Contract Type 65 Country of Birth (SACC code set) 68 Criterion for Admission 69 Date of Accident 74 Date of Birth 75 Date of Birth Accuracy 77 Diagnosis Codes 79 Duration of Mechanical Ventilation in ICU 82 Duration of Non-invasive Ventilation (NIV) in ICU 84 Duration of Stay in Cardiac/Coronary Care Unit 87 Duration of Stay in Intensive Care Unit 89 DVA ID / TAC Claim Number (Where Account Class is V- DVA) 91 DVA ID / TAC Claim Number (Where Account Class is T- TAC) 93 FIM Score on Admission (a) 94 FIM Score on Separation (b) 94 Functional Assessment Date on Admission (a) 96

Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page iii

Functional Assessment Date on Separation (b) 96 Funding Arrangement 98 Given Name(s) 101 Hospital Generated DRG 102 Hospital Insurance Fund 103 Hospital Insurance Status 106 Impairment 107 Indigenous Status 111 Intended Duration of Stay 113 Intention to Re-Admit 114 Interpreter Required 116 Leave with Permission Days Financial Year-to-Date 118 Leave with Permission Days Month-to-Date 119 Leave with Permission Days Total 120 Leave without Permission Days Financial Year-to-Date 121 Leave without Permission Days Month-to-Date 122 Leave without Permission Days Total 123 Locality 124 Marital Status 126 Medicare Number 127 Medicare Suffix 129 Mental Health Legal Status 131 Mental Health State Wide Patient Identifier 133 Mother’s UR 135 Onset Date 136 Patient Days Financial Year-to-Date 137 Patient Days Month-to-Date 138 Patient Days Total 139 Patient Identifier 141 Postcode 142 Preferred Language 144 Procedure Start Date Time 146 Procedure Codes 148 Program Identifier 150 Qualification Status 152 RUG ADL on Admission (a) 154 RUG ADL on Separation (b) 154 Separation Date 157 Separation Mode 159 Separation Referral 164 Separation Time 168 Sex………… 170 Source of Referral to Palliative Care 172 Surname 173

Page iv Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011

Transfer Destination 174 Transfer Source 176 Unique Key 178

Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page v

Introduction

This section provides the specifications for each data item collected during an admitted episode of care, and later transmitted to PRS/2.

Additional items that are included in PRS/2 transmissions, such as Trailer Record statistics and fillers, are specified in Section 5, along with the file structures of each Transaction Record.

Additional items are derived from items transmitted in PRS/2. These are referenced in Section 2 for information only. Some of these derived items are listed in the Transmitted Transaction reports (such as the DRG); others are used in edits, including age and length of stay.

Format

Information about each data item is presented in the following structured format:

Data Item Name

Specification Definition A statement that expresses the essential nature of a data item and its

differentiation from all other data items.

Data type The type of symbol, character or other designation used to represent a data

element, that is:

• Alpha/numeric - A field on which calculations are not performed. • Numeric - A field on which calculations may be performed.

Form Name or description of the form of representation for the data element such as: date, code (code set), or quantitative value.

Field size The maximum number of characters accommodated by this field.

Layout The layout of characters for the data element, expressed by a character string

representation. Examples include: ‘DDMMYYYY’ for dates, ‘N’ for a 1-digit numeric value, spaces or blank, and ‘A’ for a 1-character alpha value, spaces or blank. ‘X’ for spaces, apostrophes, hyphens, alphas or numerics.

Location The Transaction Record in which this element is transmitted to PRS/2. For

example, the Episode Record.

Reported by The requirement for this data element to be collected by public hospitals only,

or public and private hospitals (includes day procedure centres).

Reported for The specific circumstances when this data item must be reported. For example: Carer Availability is reported when the Care Type for the episode is 1, P, 2, 6, 7, K, 8, 9, F or E.

Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page 1

Reported when The stage in the episode/data submission cycle when this data element is to be reported to PRS/2. For example: Sub Acute data elements are reported following the transmission of a Separation Date in the Episode Record, not before.

Code set The set of representations of permissible values for the data item, according to

the form, layout, data type and field size.

Reporting guide Additional comments or advice on reporting the data item.

Edits A list of edits (edit numbers and long descriptors) that relate to this data

element.

Related items A list of related data items, Business Rule Tables, Concept Definitions and

Supplementary Code Lists that affect the assignment of a code in this data item.

Administration Purpose The main reason/s for the collection of this data item.

Principal data users Identifies the primary user/s of the data collected.

Collection start The year the collection of this data item commenced.

Definition source Identifies the authority that defined this data item.

Code set source Identifies the authority that developed the code set for this data item.

Page 2 Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011

Definitions

ACAS Status

Specification Definition The type of involvement of the Aged Care Assessment Service (ACAS) in

patient separation.

Data type Numeric Form Code

Field size 1 Layout N or space

Location Episode Record

Reported by Public hospitals

Private hospitals – Optional. If the private hospital chooses not to report these data items, report spaces in the field.

Reported for Episodes with Care Type 1, 2, 4, 6, 7, 8, 9, F, E and K,

And Where the patient’s age is equal to or greater than 50, And Where the episode is not a same day episode.

For Care Types P, 0, 5x and U, report spaces in this field.

Reported when A Separation Date is reported in the Episode Record.

Code set Select the first appropriate category:

Code Descriptor

1 ACAS Assessment completed during this episode

2 ACAS Assessment incomplete: referral to Sub-acute services

3 ACAS Assessment incomplete: other reason

4 ACAS Consultation only during this episode

5 No ACAS involvement during this episode

Reporting guide This information should be noted in the patient’s health record by staff members or by ACAS.

1 ACAS Assessment completed during this episode Use code 1 if the patient has received a comprehensive assessment by a member of the ACAS of their physical, medical, psychological, social and restorative care needs with a recommendation for the patient’s long term care setting and all the relevant paperwork completed (for example, 2624 certificate completed and signed if required).

2 ACAS Assessment incomplete: referral to Sub-acute services Use code 2 if the patient was seen by the ACAS who referred the patient to sub-acute services (for example, GEM or rehabilitation) at this hospital or another campus/hospital.


Excludes when the assessment was not completed because the patient:

• Required further acute care to become medically stable (use 3) • Began an assessment that was completed in a subsequent statistical

episode (use 3) • Died (use 3) • Left against medical advice (use 3)

3 ACAS Assessment incomplete: other reason Use code 3 if the patient was seen by the ACAS but a final care plan and long term care setting recommendation could not be made.

Includes when the assessment was not completed because the patient:

• Required further acute care to become medically stable. • Began an assessment that was completed in a subsequent statistical

episode. • Died. • Left against medical advice

Excludes when the assessment was not completed because the patient:

Was referred to sub-acute services (eg GEM or rehabilitation)(use 2)

4 ACAS Consultation only during this episode

Use code 4 if the ACAS were consulted, or gave advice to the Hospital staff (discharge planner, social worker) about a patient’s discharge and long term care setting and care plan options, but did not conduct a full assessment.

5 No ACAS involvement during this episode

Use code 5 if ACAS had no involvement with the patient.

Includes:

Patient referred to ACAS for a home-based assessment (record this in Separation Referral).

Edits 460 Invalid ACAS Status

461 ACAS Status not Required 462 Incompat ACAS Status and Sep Referral 533 ACAS Status Code Required

Related items Section 3: Separation Referral

Administration Purpose Assist in measuring demand, and for planning of future services.

Principal data users

Aged Care Branch (Wellbeing, Integrated Care and Aged, Department of Health)

Collection start 2003-04

Definition source Department of Health Code set source



Accommodation Type (a)

Accommodation Type on Separation (b)

Specification Definition (a) The accommodation type or types occupied by the patient during their

admission, including changes to this item during the episode.

(b) The accommodation type occupied by the patient on their last (counted) patient day.

Data type

Alphanumeric Form Code

Field size

1 Layout N or A

Location

(a) Status Segments of the Episode Record

(b) Episode Record

Reported by

All Victorian hospitals (public and private).

Reported for

All admitted episodes of care.

Reported when (a) The Episode Record is reported. Any changes in Accommodation Type are reported in new Status Segments.

(b) Once the Separation Date is reported in the Episode Record.

Code set For data items (a) and (b), select the first appropriate category:

Code Descriptor

4 In the Home (Hospital - HITH) 7 Ward Based/Medi-Hotel combination S Short Stay Observation Unit M Medical Assessment and Planning Unit 6 Emergency Department C Nursery accommodation: NICU/SCN B Other nursery accommodation or mother’s bedside (rooming in) 3 Same Day accommodation 2 Overnight accommodation: single room 1 Overnight accommodation: shared room

Reporting guide Status Segments are used to record changes of Accommodation Type during

the episode. If more than one change of Accommodation Type occurs within the same day, do not report the first change; only report the patient’s status as of midnight each day.

4 In the Home (Hospital - HITH) Approved care in accommodation outside the hospital.


Includes: Under the Hospital in the Home (HITH) program, if the public hospital’s Health Service Agreement and/or Statement of Priorities specifies the hospital is participating in this program. HITH services can only be provided to public, private, DVA, TAC and WorkCover patients. Excludes: Accommodation in a Medi-Hotel (use code 7).

7 Ward Based/Medi-Hotel combination For multi-day stay patients, where the patient receives treatment as an inpatient in a traditional hospital setting (ward) during the day and resides in the hospital’s Medi-Hotel overnight.

Includes: • Accommodation in same day facilities during the day • Where the patient is cared for in the Medi-Hotel by someone not arranged for,

provided by, or paid for by the hospital, such as a relative or other carer

Excludes: Accommodation In the Home (HITH) (use code 4).

S Short Stay Observation Unit Accommodation within an approved Short Stay Observation Unit (SOU). The facility may be in, adjacent to, or remote from the Emergency Department.

SOU is a designated unit that is specifically staffed and equipped to provide observation care and treatment for emergency patients who have an expected length of stay between 4 and 24 hours.

Includes: General and specific Short Stay Observation Units, for example chest pain units.

Excludes: • Short stay facilities designated specifically for elective surgical and

radiological procedures • Medical Assessment and Planning Unit admissions (use code M)

M Medical Assessment and Planning Unit Accommodation within an approved Medical Assessment and Planning Unit (MAPU). MAPUs concentrate on admissions for general medical conditions in one geographical area to streamline the care planning processes. Planned length of stay in the Medical Assessment and Planning Unit may be up to 48 hours prior to transfer to another Accommodation Type (ward) or separation home.

Excludes: Short Stay Observation Unit (use code S)

6 Emergency Department Patient accommodation provided in the emergency department or urgent care centre

C Nursery accommodation: NICU/SCN Accommodation provided to any infant in a facility approved by the Commonwealth Minister for the purpose of provision of neonatal intensive or special care.


B Other nursery accommodation or mother’s bedside (rooming in) Accommodation provided to any infant in a postnatal ward, either in a nursery that is not an approved NICU or SCN or by its mother’s bedside (that is ‘rooming in’).

For infants in paediatric wards, report code 1, 2 or 3 as appropriate.

3 Same Day accommodation

Same day bed or accommodation such as a renal dialysis chair, regardless of whether this bed/chair is in a single or shared room.

Excludes: Where a same day patient is accommodated in a ward or bed not designated as a same day ward/bed either because the hospital has no such designated accommodation or because that accommodation is full.

2 Overnight accommodation: single room Sole occupation of a room intended for the overnight accommodation of a single patient but only when the patient has requested single accommodation.

Includes: • Where the patient has requested single accommodation and occupies a room

intended for single occupancy but her newborn is rooming-in • Where a same day patient is accommodated in a ward/bed not designated as a

same day ward/bed either because the hospital has no such designated accommodation or because that accommodation is full

Excludes: • Where the patient is the only person occupying a room intended for shared

occupancy, such as the isolation of a patient for medical reasons, or where there is no available shared room (use code 1)

• Where the patient occupies a single room but has not requested single accommodation (use code 1)

1 Overnight accommodation: shared room

Occupation of a room intended for the overnight accommodation of more than one patient.

Includes: • Where the patient is the only person occupying a room intended for shared

occupancy • Where the patient and her rooming-in newborn are the only people occupying

a room intended for occupancy by more than one adult patient • Where the patient has not requested single accommodation but occupies a

single room because of a clinical decision • Where a same day patient accommodated in a ward/bed not designated as a

same day ward/bed either because the hospital has no such designated accommodation or because that accommodation is full

Edits (a) 076 Not Sufficient Fields First Status 077 Not Sufficient Fields Other Status 084 Invalid Accom Type 094 Combination A/C Accom Care Med Suff 106 Invalid Sep Accomm 117 Sep Accom Type Not In A Status Seg 240 Newborn Accom But Over 4 Months


329 Geri Respite - Invalid Comb 431 Newborn But Not Newborn Accom 432 MAPU or SOU >48 Hours 434 NICU/SCN Accom But Unqual Newborn 454 Incompat Fields for Interim Care 463 Accom Type 4, Care Type invalid 464 Accom Type 7, not Care Type 4 520 Accom Type 7, not approved for Medi-hotel 521 Accom Type M, no registered MAPU 522 Accom Type S, no registered SOU 602 Newborn Accom But Over 12 Months

(b) 106 Invalid Sep Accom 108 Field(s) Missing From Sep 117 Sep Accom Type Not In A Status Seg 401 Accom Type On Sep – Emerg, Not Same Day 455 Inconsist Newborn Transferred/Unqual Data

Related items Section 2: Admitted Patient, Hospital in the Home, Intensive Care Unit, and Medi-Hotel.

Section 4:

• Business Rules (non-tabular) Medi-Hotel Reporting and Reporting history of code changes.

• Business Rules (tabular) Account Class, Acc Type, Care Type and Medicare Suffix, and Account Class: Geriatric Respite, and Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member.

Section 5: Status Segments.

Section 9: Supplementary Code Lists: Medical Assessment and Planning Units (MAPU); Accommodation Type M: Neonatal Intensive Care Units and Special Care Nurseries; Accommodation Type C: Short Stay Observation Units; Accommodation Type S: and Ward Based/Medi-Hotel Combination; Accommodation Type 7.

Administration Purpose For analysis of patient movement during an episode.


Multiple internal and external data users





Account Class (a)

Account Class on Separation (b)

Specification Definition (a) The agency/individual chargeable for this episode, and associated

sub-categories, for this episode of care, including changes to this item during the episode

(b) The agency/individual chargeable for this episode, and associated sub-categories, on the last (counted) patient day

Data type Alphanumeric

Form Code

Field size 2 Layout AA or AN

Location (a) Status Segments of the Episode Record

(b) Episode Record

Reported by All Victorian hospitals (public and private)

Reported for All admitted episodes of care

Reported when (a) The Episode Record is reported

(b) Once the Separation Date is reported in the Episode Record

Code set Code Descriptor

Unqualified Newborns (Not Birth Episode)

NT Newborn (Unqualified, Not birth episode) Public (Acute Care) Patient

MP Public: Eligible ME Ineligible: hospital exempt MF Ineligible: Asylum Seeker MR Geriatric respite care MN Public NHT – without NH5 M5 Public NHT - with NH5 MA Reciprocal Health Care Agreement Private Patient

PA Advanced surgery 1 (1-14 days) PB Advanced surgery 2 (15+ days) PC Surgery (1-14 days) PD Surgery 2 (15+ days) PE Medical 1 (1-14 days) PF Medical 2 (15+ days) PG Obstetric 1 (1-14 days) PH Obstetric 2 (15+ days) PI Rehabilitation 1 (1-49 days) PJ Rehabilitation 2 (50-65 days) PK Rehabilitation 3 (66+ days) PL Psychiatric 1 (1-42 days) PM Psychiatric 2 (43-65 days) PN Psychiatric 3 (66+ days)


PO Same Day (Band 1) PP Same Day (Band 2) PQ Same Day (Band 3) PR Same Day (Band 4) PS Private NHT - with general care-without NH5 PT Private NHT - with general care-with NH5 PU Private NHT - with extensive care-without NH5 PV Private NHT - with extensive care-with NH5 Department of Veterans’ Affairs Patient

VX Department of Veterans’ Affairs (DVA) VN Department of Veterans Affairs NHT-without NH5 V5 Department of Veterans’ Affairs NHT-with NH5 Compensable Patient

WC Victorian WorkCover Authority (VWA) WN Victorian WorkCover Authority (VWA) - Non-Acute TA Transport Accident Commission (TAC) TN Transport Accident Commission (TAC) - Non-Acute AS Armed Services AN Armed Services - Non-Acute SS Seamen SN Seamen - Non-Acute CL Common Law Recoveries CN Common Law Recoveries - Non-Acute OO Other compensable ON Other compensable - Non-Acute JP Prisoner JN Prisoner Non-Acute Ineligible

XX Ineligible non-Australian residents (not exempted from fees) XN Ineligible non-Australian residents (not exempted from fees) - Non-

Acute Reporting guide Status Segments are used to record changes of Account Class during the

episode. If more than one change occurs within the same day, do not report the first change; only report the patient’s status as of midnight each day.

Note: An episode cannot have both public and compensable Account Classes in different status segments.

Newborns are expected to have the same Account Class as their mother for the birth episode. In certain circumstances in public hospitals, the mother may be public and the baby private, or the mother private and the baby public. For example:

• Where the mother does not have private insurance and elects for the baby to be treated as private and pay all expenses; and

• Where the mother has single private insurance and elects to be private, the baby can be a public patient.

Where the newborn is unqualified and it is not the birth episode, report Account Class NT.


NT Newborn (Unqualified, Not birth episode) A newborn (under 10 days old at admission), admitted subsequent to the birth episode (where the Account Class should be the same as the mother’s) who does not meet the criteria for a qualified newborn. Usually these babies are transferred from another hospital.

Note: The newborn may have been reported as qualified or unqualified at a prior hospital

MP Public: Eligible An eligible person, who, on admission to a recognised hospital or a private hospital for services provided under contract, or as soon as possible thereafter, elects to be treated as a public patient. The hospital provides comprehensive care including all necessary medical, nursing and diagnostic services and, if available, dental and paramedical services, by means of its own staff or by other agreed arrangements, without charge to the patient.

Includes: Persons holding a current Interim Medicare Card.

Excludes: • Persons holding an expired Interim Medicare Card (report XX Ineligible) • A person admitted to a private facility where the hospital and/or clinician bulk

bill Medicare for the patient’s treatment

ME Ineligible: Hospital Exempt

An ineligible non-Australian resident: • Specifically referred to Australia for hospital services not available in the

patient’s own country and for whom the Secretary of the Department has determined that no fee be charged; or

• Who has been declared a safe haven resident and whose treatment is provided or arranged by a designated hospital

MF Ineligible: Asylum Seeker

A Medicare ineligible asylum seeker. • Admitted for immediately necessary medical treatment (but only as a public

patient); and • Has met the criteria for Medicare Ineligible Asylum Seeker

MR Geriatric Respite Care

A patient admitted for geriatric respite care. After 35 days of continuous hospitalisation, the patient can be classified as a NHT patient.

MN Public NHT – without Aged Care Client Record

A patient as defined in section 3 of Commonwealth Health Insurance Act: after 35 days continuous hospitalisation, the patient is classified as a NHT patient unless a medical practitioner certifies that the patient is in need of acute care.

For example: • Professional attention for an acute phase of the patient’s condition; or • Active rehabilitation; or


• Continued management, for medical reasons, as an admitted patient.

Nursing Home Type patients can be of the following types: • Public • Private with general care • Private with extensive care • DVA with general care • DVA with extensive care

If a NHT patient is out of a hospital for seven days or less and is readmitted, the count of days continues (the days out of hospital are not added). If a NHT patient is out of hospital for more than seven consecutive days, the patient is formally separated. If the patient later returns to the hospital, the patient is formally admitted as an acute patient.

M5 Public NHT – with Aged Care Client Record

A NHT patient who has been assessed by an Aged Care Assessment Team and has an approved Aged Care Client Record.

MA Reciprocal Health Care Agreement

A visitor to Australia who is ordinarily resident in a country with which Australia has a Reciprocal Health Care Agreement (RHCA), admitted for necessary medical treatment (but only as a public patient), as is clinically necessary for the diagnosis, alleviation or care of the condition requiring attention, on terms no less favourable than would apply to a resident.

P Private Patient A person who elects in writing to be treated (in a public or private hospital) as an admitted patient by a medical practitioner of their own choice and to be responsible for paying the charges referred to in clause B13 of the 2009 National Healthcare Agreement.

Includes: • A patient on whose behalf election has been made by another person with

patient’s express or implied consent • A patient admitted to a private facility where the hospital and/or clinician bulk

bill Medicare for the patient’s treatment

Clause B13 of the National Healthcare Agreement states ‘Private patients, compensable patients and ineligible patients may be charged an amount for public hospital services as determined by the State and Territory’.


V Department of Veterans’ Affairs Patient

An eligible person whose charges for this episode of care are met by the Department of Veterans’ Affairs (DVA). A gold card holder is automatically eligible as a veteran, but a white card holder’s eligibility must be established at the time of admission or on the next business day if the patient is admitted over a weekend (contact Department of Veterans’ Affairs, State office, telephone (03) 9284 6111 or fax (03) 9284 6440). If DVA does not accept responsibility, then normal patient election applies.

Public hospitals: If the first character of the patient’s Account Class is V, a V4 DVA and TAC Record must be transmitted every time the Episode Record is transmitted.

-- Compensable Patient

An eligible person who is an admitted patient and who is entitled under a law that is or was in force in Victoria, other than Veterans’ Affairs legislation, to the payment of, or who has been paid compensation for, damages or other benefits (including a payment in settlement of a claim for compensation, damages, or other benefits) in respect of the injury, illness or disease for which he/she is receiving hospital services.

This category includes workers compensation, transport accident, criminal injury and common law cases and members of the Defence Forces and seamen with personnel entitlements.

Clause B13 of the National Healthcare Agreement states ‘Private patients, compensable patients and ineligible patients may be charged an amount for public hospital services as determined by the State and Territory.’

- N Compensable Non-Acute Patient

A person, who has been admitted in one or more hospitals (public and private) for a continuous period of more than 35 days with a maximum break of seven consecutive days and who, if not a compensable patient, would be deemed to be a Nursing Home Type patient.

J Prisoner Patient

A person who is an admitted patient and is currently in the custody of Correctional Services in Victoria.

• Prisoners may be transferred to a public hospital for treatment on an admitted or non-admitted basis. Funding for these services is not provided by the Commonwealth through the National Healthcare Agreement. Hence, the department does not recognise these patients for casemix or VACS payments. Funding for prisoners' health care is provided to prison authorities by the Department of Justice and prison authorities are responsible for meeting all costs incurred by hospitals in the treatment of such patients.

• Hospitals are required to bill ‘Australian Correctional Management’ directly


XX Ineligible Non-Australian Resident Patient

A person who is an admitted patient but who is not eligible for Medicare and therefore not exempted from fees.

Includes: Persons holding expired Interim Medicare Cards (should be billed for services).

Clause B13 of the National Healthcare Agreement states ‘Private patients, compensable patients and ineligible patients may be charged an amount for public hospital services as determined by the State and Territory’.

XN Ineligible Non-Australian Resident - Non-Acute Patient

A person who has been admitted in one or more hospitals (public and private) for a continuous period of more than 35 days with a maximum break of seven consecutive days and who, if not an ineligible patient, would be deemed to be a Nursing Home Type patient.

Public hospitals:

Report the patient’s Account Class according to the Fees and Charges for Acute Health Services in Victoria - A Handbook for Public Hospitals document, available at: http://www.health.vic.gov.au/feesman/index.htm

The patient elects to be treated as a Public or Private patient, or may be eligible for DVA or a compensable class, or may be ineligible. Refer to above document for the correct wording for the ‘Form of Election for Admission to Public Hospital’.

After admission and initial election, patient election status can only be changed in the event of unforseen circumstances. Examples of unforseen circumstances include, but are not limited to:

• Patients who are admitted for a particular procedure but are found to have complications requiring additional procedures;

• Patients whose length of stay has been extended beyond those originally and reasonably planned by an appropriate health professional; and

• Patients whose social circumstances change while in hospital (for example, loss of job).

Inadequate private health insurance cover is not a sufficient reason for changing a patient’s election status.

Private Patients:

Within each broad Account Class, categorisation of patients is a medical decision and is performed by medical staff at the hospital or the referring medical practitioner; patients cannot elect to be charged as a particular Account Class as this will depend on what surgery, if any, is performed and complexity of the care.

Fees depend on whether the patient has been an admitted patient in any

hospital within the seven days before this admission. Previous hospitalisation may alter the patient’s length of stay classification.

Private patients specify on the election form whether they wish to be accommodated in a single room.


http://www.health.vic.gov.au/feesman/index.htm

The fee charged to a private patient will depend upon:

• Patient account classification and length of stay • Type of accommodation

Private hospitals:

Record patient Account Class as ‘best fit’ Account Class according to the Fees and Charges for Acute Health Services in Victoria - A Handbook for Public Hospitals document.

Because of the many patient account options used in private hospitals, and the limited applicability of the comparatively small range of Account Classes offered in PRS/2, private hospitals and day procedure centres are not required to supply comprehensive Account Class data. Only the following broad categories apply:

Contracted patients: Use the appropriate Account Class from the range of valid

codes. Where public patients are admitted under contract, use code MP.

A patient admitted to a private facility where the hospital and/or clinician bulk bill Medicare for the patient’s treatment is not considered to be a public patient. These patients should be reported using an appropriate private account class.

If a patient is admitted as fee-paying but is unable/unwilling to pay their account and the fee is written off, the original Account Class should be used (for example, PE, PC). Do not change the Account Class to a Medicare no-charge category.

For all private acute same day patients, use any code respectively, from the following list:

PO PP PQ PR

For all private acute overnight/multi-day patients, use a code starting P, with any valid combination of second character, from the following list:

PA PB PC PD PE PF PG PH PI PJ PK PL PM PN

Nursing Home Type patients (Private and Department of Veterans’ Affairs) must be classed to the existing range of codes:

PS PT PU PV VN V5

However, accurate specification of general or extensive care level or NH5 status

is not required for private hospital NHT or Department of Veterans’ Affairs NHT patients.

Compensable or Ineligible patients should be identified as such, including detail of the relevant funder. These patients need only be classified to the following level of detail:

WC TA AS SS CL OO XX

There is no requirement to use the codes with second-character N.

Edits (a) 076 Not Sufficient Fields First Status 077 Not Sufficient Fields Other Status 083 Invalid Account Class 094 Combination A/C Accom Care Med Suff 111 Same Day A/C Stat Not The Only Status


113 Same Day Status: Total Pt Days Not 1 116 Sep A/C Class Not In A Status Seg 222 Unqual Newborn; Adm Date Not Birth 324 Incompat ICU Hrs, A/C Class 325 Incompat MV Hrs, Acct Class 329 Geri Respite - Invalid comb 372 Episode Deletion: Multiple Epis Trans 374 Episode DVA/TAC: No V4 Transaction 375 Episode DVA/TAC: V4 Trans Rejected 377 Episode DVA/TAC: Multiple E4 Trans 378 Episode DVA/TAC: Multiple V4 Trans 379 Epis Not DVA/TAC: V4 Trans Present 380 Epis Not DVA/TAC: V4 Trans: Multiple E4s 382 Epis Not DVA/TAC: Multiple V4 Trans 391 Recip HCA Account, Not O/Seas P/Code 392 Recip HCA Account, Not O/Seas Born 393 Recip HCA Account, Indig Stat A or TI 454 Incompat Fields for Interim Care 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 532 Account Class MA: not 4, 5E, 5K, 5G, 5S, 5A or U 571 Acct Recip, Pcode Oseas, Locality Not RHCA 572 Postcode Overseas, Account Not Recip, or Inelig 573 Postcode Overseas, Account Public 574 Postcode Overseas, Locality RHCA, Acct Not RHCA 603 CCU Account Class, No CCU Hours 604 ICU Account Class, No ICU Hours 605 Priv Pt, CCU Hours, no CCU Account Class 606 Priv Pt, ICU Hours, no ICU Account Class 615 HDU Account Class, no approved ICU 616 ICU Account Class, no approved ICU 617 CCU Account Class, no approved CCU 626 Invalid Combination for Funding Arrangement PHESI 637 Illegal Combination of Account Classes 638 Private Hosp, Public Account Without Contract

(b) 105 Invalid Sep Account Class 108 Field(s) missing From Sep 116 Sep A/C Class Not In A Status Seg 454 Incompat Fields for Interim Care 455 Inconsist Newborn Transferred/Unqual Data

Related Items Section 2: Boarder, Medicare Eligibility Status - Eligible Person, Medicare Eligibility Status - Ineligible Person, and Newborn

Section 4: • Business Rules (non-tabular) Newborn Reporting, and Reporting history of

code changes. • Business Rules (tabular) Account Class, Acc Type, Care Type and Medicare

Suffix and Account Class: Geriatric Respite, and Care Type: Interim Care Program (F and E), and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative.

Section 5: Status Segments


Administration Purpose (a) To:

Distinguish between broad categories (public, private, DVA, compensable).

Identify patients with DVA account classes (for accounting purposes).

Identify certain compensable patients (so DRG Statements are raised).

Verify other fields (such as Care Type, Accommodation Type) for consistency.

(a) To identify the Account Class of a patient at separation: For use in summary analyses.

To place patients into broad account categories for reporting to the Commonwealth.

Principal data users Chief Finance Officer (Strategy, Policy and Finance), DH)

Department of Veterans’ Affairs (DVA)

Transport Accident Commission (TAC)

WorkCover (VWA)


Definition source Department of Health Code set

source Department of Health

Account Classes on Separation mapped to the Separation Patient Type Code (derived item) Account Class on Separation (first character of Account Class) Separation Patient Type M, N H Public P P Private V V DVA W, T, A, S, C, O, J S Compensable X X Ineligible

Account Classes mapped to AIMS Trailer Record fields -Private Hospitals and Day Procedure Centres AIMS Statistics Category Account Classes Private – Acute (both Separations and Patient Days)

PA, PB, PC, PD, PE, PF, PG, PH, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, VX

Private – Nursing Home Type (both Separations and Patient Days)

PS, PT, PU, PV, VN, V5

Compensable (both Separations and Patient Days)

JP, JN, WC, WN, TA, TN, AS, AN, SS, SN, CL, CN, OO, ON

Ineligible (both Separations and Patient Days)

XX, XN

Public – Under Contract (both Separations and Patient Days)

MP

Private – Same Day PA, PB, PC, PD, PE, PF, PG, PH, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, PS, PT, PU, PV, VX, VN, V5

Compensable – Same Day JP, JN, WC, WN, TA, TN, AS, AN, SS, SN, CL, CN, OO, ON Ineligible – Same Day XX, XN Public – Under Contract – Same Day MP


Account Classes mapped to AIMS Trailer Record fields -Public Hospitals AIMS Statistics Category Account Classes Public – Acute (both Separations and Patient Days)

MP, ME, MF, MR, MA

Private – Acute (both Separations and Patient Days)

PA, PB, PC, PD, PE, PF, PG, PH, PI, PJ, PK, PL, PM, PN, PO, PP, PQ, PR, VX

Compensable – Acute (both Separations and Patient Days)

JP, WC, TA, AS, SS, CL, OO

Ineligible – Acute (both Separations and Patient Days)

XX

Public NHT – NH5 (both Separations and Patient Days)

M5

Public NHT – Non NH5 (both Separations and Patient Days)

MN

Private NHT – NH5 (both Separations and Patient Days)

PT, PV, V5

Private NHT – Non NH5 (both Separations and Patient Days)

PS, PU, VN

Compensable – Non-Acute (both Separations and Patient Days)

JN, WN, TN, AN, SN, CN, ON

Ineligible – Non-Acute (both Separations and Patient Days)

XN

Public – Same Day MP, ME, MF, MN, M5, MA, MR Private – Same Day PA, PB, PC, PD, PE, PF, PG, PH, PI, PJ, PK, PL, PM, PN, PO, PP,

PQ, PR, PS, PT, PU, PV, VX, VN, V5 Compensable – Same Day JP, JM, WC, WN, TA, TN, AS, AN, SS, SN, CL, CN, OO, ON Ineligible – Same Day XX, XN


Admission Date

Specification Definition Date on which an admitted patient commences an episode of care (formal or

statistical).

Data type Numeric Form Date

Field size 8 Layout DDMMYYYY

Location

Episode Record

DVA and TAC Record

Reported by All Victorian hospitals (public and private).

Private hospitals: Do not report a DVA and TAC Record.

Reported for All admitted episodes of care

Reported when The Episode Record or DVA and TAC Record is reported

Code set Valid date

Reporting guide Admission of Birth Episode

For the first episode of a Newborn, the Admission Date will be the Date of Birth, except in the unusual circumstance where the newborn is born before arrival at this hospital, and where the birth occurs just before midnight and the newborn arrives at this hospital after midnight.

Admission from Non-admitted Services

Non-admitted (emergency or outpatient) services provided to a patient who is subsequently classified as an admitted patient shall be regarded as part of the admitted episode. Any occasion of service should be recorded and identified as part of the admitted patient’s episode of care. For example, when a patient is admitted from the Emergency Department, then the admission time is the time treatment was started in the Emergency Department. That is, when the patient was first treated by a nurse or doctor, whichever comes first, rather than the time the decision is taken to admit the patient. In this context, ‘treatment’ includes commencement of baseline observations by a nurse and assessment of the patient by a doctor.

Statistical Admissions

Statistical admissions must have an Admission Date equalling the previous episode’s Separation Date. Statistical separations and admissions cannot occur over midnight.


Edits 026 Zero Sep; Existing Not Discharged 027 Adm Record; Overlaps Existing 028 Prior Adm; No Sep Date 035 Invalid Date of Birth 038 Invalid Adm Date 039 Invalid Adm Date; > Header 057 Incompat Adm Type/Age 061 Married – Age Not Within Range 062 Duplicate Pt ID, Adm Date Time, Diff. Unique 063 Prior Not Discharged 064 Duplicate Pt ID, Date Time 069 Newborn From Overseas 074 Invalid Age For Criterion 080 Sex Indeterminate Age< 90 Days 102 Sep Date < Adm Date 112 Calc Los + Leave Not = Adm/Sep 115 Adm Time Not< Sep Time 122 Sameday Adm Source/Sep Mode Mismatch 127 Nil Value DRG 160 AR-DRG Grouper GST Code> Zero 178 Trans Adm Not Same As Episode 186 Neonate MDC But Age > = 28 days 187 Adm Weight Too Low 188 Adm Weight Too High 189 Age < 1 Year But Adm Weight Missing 190 Adm Wt Present But Not Aged < 1 Year 215 Sex Indeterminate But Age >9 Days 222 Unqual Newborn; Adm Date Not Birth 226 Adm Date Before Birth Date 227 Age Calculated As 120 Years & Over 240 Newborn Accom But Over 4 Months 245 Adm Wt >=9Kg But Age >=5 Mth 255 Rehab: Invalid Onset Date 261 Newborn Care Type But Age >9 days 262 Invalid Care Type For Newborn 289 Adm Sc T’fer & Onset =Adm Date 290 Stat Adm Sc, & Onset = Adm Date 322 ICU/CCU Stay > Total Stay 323 MV Duration > Total Stay 329 Geri Respite Invalid Comb 353 Code & Age Incompatible 390 Incompat Care Type, Carer Avail, Age and Sep Mode 397 Sep Referral Postnatal, Incompat Age/Sex 401 Accom Type On Sep - Emerg, Not Same Day 431 Newborn But Not Newborn Accom 438 NIV Duration > Total Stay 447 Unqual Newborn; Age at Sep > 10 Days 454 Incompat Fields for Interim Care 461 ACAS Status not Required 465 Adm Duration < 15 Mins 467 Adm Wt <1000g, LOS <28 Days, Sep Mode ≠ T or D 468 Care Type ≠ 1 or F, LOS >365 Days 474 Care Type E, LOS > 35 Days


479 Incompat Adm Source/Age 480 Incompat Adm Source/Age <15 481 Incompat Adm Source/Age <55 486 Incompat Age/Crit for Adm 487 Incompat Age/Qual Stat 493 Incompat Sep Mode/Age <15 494 Incompat Sep Mode/Age <55 504 Stat Episode: Next Episode > 1 Minute Apart 505 Stat Episode: Previous Episode > 1 Minute Apart 518 Medicare Code = 0, Age > 6 Months 519 Medicare Code = 0, Age > 12 Months 533 ACAS Status Code Required 542 MH Acute Adult Care Type But Age < 14 Years 543 MH Acute Adult Care Type But Age > 65 Years 544 MH APMHS Care Type But Age < 55 Years 545 MH CAMHS Care Type But Age < 5 Years 546 MH CAMHS Care Type But Age > 19 Years 547 MH SECU Care Type But Age < 14 Years 548 MH Specialist Acute Care Type But Age < 14 Years 549 Type B Crit for Adm, LOS >1 550 Type C Crit for Adm, LOS >1 551 Type C Crit for Adm, LOS >4 hrs 552 Type E Crit for Adm, LOS >1 553 Type E Crit for Adm, LOS <4 hrs 554 Date of Accident > Adm Date 596 Same Day ECT: Not in Care Type 4 598 Same Day Rehabilitation: Not in Scope 602 Newborn Accom But over 12 Months

Related items Section 2: Age, Length of Stay, Overnight or Multi-day Stay Patient, and Same Day Patient.

Section 3: Date of Birth.

Section 4:

• Business Rules (non-tabular) Length of Stay • Business Rules (tabular): Admission Source and Age; Admission Type and

Age; Age and Criterion for Admission; Age, Care Type, Carer Availability and Separation Mode.

Administration Purpose To enable (for data validation purposes) ‘patient days’ (patient’s length of stay)

and normal leave days to be balanced with the difference between Admission Date and Separation Date.

To enable calculation of age.


Multiple internal and external data users.

Collection start

1979-80

Definition source NHDD


Admission/Re-Admission to Rehabilitation

Specification Definition Indicates whether this is the first or subsequent rehabilitation episode for a

particular injury/condition.

Data type

Numeric Form Code

Field size

1 Layout N or space

Location Sub-Acute Record

Reported by Public hospitals.

Reported for Care Types P, 2, 6, 7 and K. For Care Types 8, 9, F and E, report a space.



0 First rehabilitation admission 1 Re-admission for rehabilitation Reporting guide 0 First rehabilitation admission

Patient’s current admission is their first rehabilitation episode for this condition.

1 Re-admission for rehabilitation

Patient’s current admission is a re-admission for rehabilitation for this condition.

Edits 254 Rehab - Invalid Adm/Re-Adm to Rehab

258 Sub-Acute: No Sub-Acute Record 295 Adm/Readmit to Rehab Present 454 Incompat Fields for Interim Care

Related items Section 2: Rehabilitation Care

Section 4: Business Rules (tabular) Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type: Designated Paediatric Rehabilitation Program (P), and Care Type: Interim Care Program (F and E).

Administration Purpose To support and further develop casemix classifications for sub-acute episodes of

care.


Continuing Care and Clinical Service Development (Hospital & Health Service Performance, Department of Health).





Admission Source

Specification Definition Describes where the patient was residing or living prior to the commencement of

an episode of care.

Data type

Alpha Form Code

Field size

1 Layout A

Location

Episode Record


Reported for All admitted episodes of care.

Reported when The Episode Record is reported.


Code Descriptor

S Statistical Admission (change in Care Type within the hospital) Y Birth episode T Transfer from acute hospital/extended care/rehabilitation/geriatric

centre B Transfer from Transition Care bed based program A Transfer from mental health residential facility N Transfer from aged care residential facility H Admission from private residence/accommodation

Reporting guide S Statistical Admission (change in Care Type within this hospital)

Assign this code when a new episode of care has commenced within the same hospital stay on the same hospital campus.

Excludes:

• Change from or to Unqualified newborn (Care Type U) as a Statistical Separation or a Statistical Admission. Changes between Qualified and Unqualified status of newborns are recorded in Status Segments using the Qualification Status field. Refer to Section 4: Newborn.

• Change between Rehabilitation Program/Units: Levels 1, 2, 3 or Paediatric, Care Types (2, 6, 7, P).

Y Birth episode Admission of newborn at or directly after birth.

Excludes second or subsequent admissions in the newborn period: Newborns admitted after the birth episode, while still nine (9) days old or less (use code T or H).


T Transfer from acute hospital / extended care / rehabilitation / geriatric centre

Admission to this hospital, directly from another acute hospital, extended care, rehabilitation or geriatric centre, regardless of whether the patient was admitted or not at the transferring hospital. Requires a Transfer Source code.

Includes:

Public and private acute, extended care and mental health admitted patient units.

Excludes:

• Transition Care bed based program (use code B) • Aged care residential facilities (use code N) • Mental health residential facility (use code A).

B Transfer from Transition Care bed based program

Admission to hospital directly from a Transition Care bed based program. Does not require a Transfer Source code.

Excludes:

Home-based Transition Care.

A Transfer from mental health residential facility

Transfer from mental health residential facility (includes Psychogeriatric nursing homes and community care units) (Rehabilitation/Continuing Care/Other Care) funded by Mental Health Services. Only mental health residential facilities listed in Section 9 apply to this code. Does not require a Transfer Source code.

Includes:

Mental health aged care residential facility.

Excludes:

Mental health admitted patient units (use code T).

N Transfer from aged care residential facility

Admission to hospital directly from an aged care residential facility (includes nursing home and hostel). Does not require a Transfer Source code.

Excludes:

• Transition Care bed based program (use code B) • Mental health aged care residential facility (use code A).


H Private Residence/Accommodation

Place of residence immediately prior to admission.

Includes:

• Home or home of relative or friend. • Supported residential facilities. • Special accommodation houses. • Training centres for intellectually disabled persons. • Prison. • Forensic hospital (Thomas Embling). • Juvenile detention centre. • Armed forces base camp/hospital. • Homeless (shelters, half way houses).

Excludes:

• Transition Care bed based program (use code B). • Aged care residential facility (use code N). • Mental health residential facility (use code A).

Edits 041 Invalid Adm Source 051 Transfer Source Blank 056 Incompatible Adm Type/Source 122 Sameday Adm Source/Sep Mode Mismatch 289 Adm Sc T’fer & Onset = Adm Date 290 Stat Adm Sc & Onset Date = Adm Date 328 Early Parenting Centre – Invalid Comb 329 Geri Respite – Invalid Comb 336 Invalid comb For Crit Care Transfer 423 Invalid Comb Fund/Contract/Transfer 454 Incompat Fields for Interim Care 479 Incompat Adm Source/Age 480 Incompat Adm Source/Age <15 481 Incompat Adm Source/Age <55 482 Incompat Adm Source/Crit for Adm 483 Incompat Adm Source/Qual Stat 488 Incompat Care Type/Adm Source Statistical 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 499 Stat Admission: No Prev Episode 501 Stat Episode: Adm Source ≠ Sep Mode Prev Episode 503 Stat Episode: Care Type same as Prior Episode 505 Stat Episode: Previous Episode > 1 Minute Apart 507 Stat Episode: Rehab also in Prior Episode 509 Stat Episode: Sep Mode ≠ Adm Source Next Episode 510 Stat Sep Mode: No Subsequent Episode 626 Invalid Combination for Funding Arrangement PHESI 629 Incompatible Adm Source/Indigenous Status

Related items Section 2: Admission, Admitted Patient, Episode of Admitted Patient Care, Geriatric Evaluation and Management Program, Hospital Stay, Interim Care, Newborns, Nursing Home Type/Non-Acute care, Palliative Care, Rehabilitation Care and Transfer.


Section 3: Transfer Source.

Section 4:

• Business Rules (non-tabular) Episode of Care, Newborn and Transfer • Business Rules (tabular) Account Class: Geriatric Respite, and Admission

Source and Admission Type, and Admission Source and Age, and Admission Source and Care Type, and Admission Source and Criterion For Admission, and Admission Source and Qualification Status, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and, Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Contracting: Funding Arrangement, Contract Type and Contract Role with Admission Source and Separation Mode, and Criterion for Admission: Secondary Family Member, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative and Funding Arrangement: Private Hospital Elective Surgery Initiative.

Administration Purpose To analyse patient movement.

Principal data users Multiple internal and external data users.


Definition source NHDD Code set



Admission Time

Specification Definition Time at which an admitted patient commences an episode of care.

Data type

Numeric Form (24 Hour) Time

Field size

4 Layout HHMM

Location

Episode Record




Code set A valid 24-hour time (not 0000 or 2400).

Reporting guide For a formal admission, the Admission Time is the actual time at which patient

was admitted (at the admission desk), the time of birth, or the time care commenced in the Emergency Department (see below).

For a statistical admission (Care Type change), a dummy Admission Time is acceptable to enable the times to be automatically recorded. Care Type changes could be recorded as occurring at midday. The Admission Time must be one minute later than the Separation Time of the preceding episode (for example, if Separation Time of the earlier episode was made to be 1200, Admission Time of the new episode would be 1201).

Midnight

Following international convention, midnight is either 2359 of preceding date or 0001 of following date (0000 and 2400 are not accepted).

Newborns

• For newborns born in this hospital, the Admission Time is the time of birth. • For newborns born before arrival or transferred to this hospital from another,

the Admission Time is time of arrival at this hospital.


Admission from Non-admitted Services

Non-admitted (emergency or outpatient) services provided to a patient who is subsequently classified as an admitted patient shall be regarded as part of the admitted episode. Any occasion of service should be recorded and identified as part of the admitted patient’s episode of care. For example, when a patient is admitted from the Emergency Department, then the Admission Time is the time treatment was started in the Emergency Department. That is, when the patient was first treated by a nurse or doctor, whichever comes first, rather than the time the decision is taken to admit the patient. In this context, ‘treatment’ includes commencement of baseline observations by a nurse and assessment of the patient by a doctor.

Edits 027 Adm Record; Overlaps Existing

040 Invalid Adm Time 062 Duplicate Pt ID, Adm Date Time, Diff Unique 064 Duplicate Pt ID, Date Time 115 Adm Time Not < Sep Time 322 ICU/CCU Stay > Total Stay 323 MV Duration > Total Stay 438 NIV Duration >Total Stay 465 Adm Duration < 15 Mins 504 Stat Episode: Next Episode > 1 Minute Apart 505 Stat Episode: Previous Episode > 1 Minute Apart 551 Type C Crit for Adm, LOS >4 hrs 553 Type E Crit for Adm, LOS <4 hrs

Related items Section 3: Admission Date

Administration Purpose To enable the exact Length of Stay to be determined.



Collection start

1990-91



Admission Type

Specification Definition The category of admission (patient characteristic) relating to this episode of care.

Data type

Alpha Form Code

Field size

1 Layout A

Location

Episode Record





Code Descriptor

S Statistical admission (change in Care Type within this hospital) Y Birth episode M Maternity C Emergency admission through Emergency Department at this hospital

(VEMD reporting hospitals only) L Admission – from the Waiting List (ESIS reporting hospitals only) O Other emergency admission X Other admission

Reporting guide S Statistical admission (change in Care Type within this hospital)

Used for statistical admissions.

Y Birth episode

Admission of newborn at or directly after birth.

Excludes second or subsequent admissions in the newborn period:

Newborns admitted after the birth episode, while still nine (9) days old or less (use code C, L, O or X).

M Maternity

Admission of a pregnant female of 20 or more weeks' gestation, or a female within 42 days of her having given birth, for a condition primarily related to her current or recent pregnancy.


C Emergency admission through Emergency Department at this hospital (VEMD reporting hospitals only)

Admission of an emergency patient, arising from presentation at the Emergency Department of this hospital.

Use of this code is limited to those facilities that report to the Victorian Emergency Minimum Dataset (VEMD).

Includes: Threatened miscarriage before 20 weeks.

Excludes: Admission of a pregnant female of 20 or more weeks' gestation, or a female within 42 days of her having given birth, for a condition primarily related to her current or recent pregnancy (use M).

L Admission – from the Waiting List (ESIS reporting hospitals only)

Admission of a patient currently on the waiting list for elective medical or surgical treatment as an admitted patient. Waiting list patients include only those elective admissions for which names, addresses and other necessary details are held by the hospital on a specific list prepared from a written request for admission from the patient’s doctor.

Use of this code is limited to those facilities that report elective surgery waiting list data to the Elective Surgery Information System (ESIS).

Excludes: Admission of a pregnant female of 20 or more weeks' gestation, or a female within 42 days of her having given birth, for a condition primarily related to her current or recent pregnancy (use M).

O Other emergency admission

Admission of an emergency patient, not arising from presentation at the Emergency Department at this hospital, or arising from presentation at the Emergency Department of a hospital which does not report data to the Victorian Emergency Minimum Dataset (VEMD).

Includes:

• GP-referred admission or self-referral for acute illness (such as unstable diabetes, CCF, pneumonia, asthma attack) directly for emergency admission.

• Threatened miscarriage before 20 weeks. • Emergency admission to a hospital without a formal Emergency Department. • Admission from Outpatient Department where patient is an emergency

patient.

Excludes:

• Admission of a pregnant female of 20 or more weeks' gestation, or a female within 42 days of her having given birth, for a condition primarily related to her current or recent pregnancy (use M).

• Admission via the emergency department where the hospital reports to the VEMD (use C).


X Other admission

Routine or elective admission regardless of expected length of stay, where the patient is not recorded on the waiting list or the patient is recorded on a waiting list of a hospital which does not report to the Elective Surgery Information System (ESIS).

Includes:

• Admission from the waiting list of a hospital which does not report to the Elective Surgery Information System (ESIS).

• Planned admission for the patient to receive limited care or treatment for a current condition, for example dialysis or chemotherapy.

• Admission from Outpatient Department where patient is an elective patient. • Follow-up admission following a previous emergency admission or

presentation where the patient has not been added to an elective surgery waiting list.

Edits 052 Invalid Adm Type

056 Incompatible Adm Type/Source 057 Incompat Adm Type/Age 059 Maternity - Not Female 328 Early Parenting Centre – Invalid Comb 329 Geri Respite - Invalid Comb 336 Invalid Comb For Crit Care Transfer 454 Incompat Fields for Interim Care 455 Inconsist Newborn Transferred/Unqual Data 466 Adm Type L & Newborn Qual Status 484 Incompat Adm Type/Crit for Adm 485 Incompat Adm Type/Qual Stat 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 626 Invalid Combination for Funding Arrangement PHESI 633 Delivery Episode, Adm Type not M

Related items Section 2: Admission, Geriatric Respite, Newborn, and Urgency of Admission.

Section 4:

• Business Rules (non-tabular) Newborn Reporting. • Business Rules (tabular) Account Class: Geriatric Respite, and Admission

Source and Admission Type, and Admission Type and Age, and Admission Type and Criterion For Admission, and Admission Type and Qualification Status, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission, Age, Admission Type, Admission Source, Qualification Status, and Criterion for Admission: Secondary Family Member, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative and Funding Arrangement: Private Hospital Elective Surgery Initiative.


Administration Purpose To:

• Distinguish between emergency and non-emergency admissions. • Monitor admissions from the Waiting List. Identify data for maternity and birth episodes.

Principal data users Funding & Information Policy Branch (Hospital & Health Service Performance, Department of Health).





Admission Weight

Specification Definition The birth weight of the live baby or the weight of the neonate or infant (under

one year of age) on the date admitted, if this is different from the date of birth.

Data type

Numeric Form Quantitative value

Field size

4 Layout NNNN or spaces.

Right justify, leading zeros.

Location

Diagnosis Record


Reported for All admitted patients under 1 year of age.


Code set Valid weight in grams, 100-9999. If Admission Weight is not required, transmit

spaces, not zeros.

Reporting guide Admission Weight is required for all infants under 1 year of age at admission

(that is, admitted on a date earlier than the infant’s first birthday).

Where the admission starts on the day of birth, the birth weight is the Admission Weight.

If Admission Weight is unknown or heavier than 9999, and the patient is aged greater than 27 days, use 9999. If the patient is less than 28 days, estimate the weight.

Edits 127 Nil Value DRG

160 AR-DRG Grouper GST Code > Zero 187 Adm Weight Too Low 188 Adm Weight Too High 189 Age < 1 Year But Adm Weight Missing 190 Adm Wt Present But Not Aged < 1 Year 245 Adm Wt >= 9kg But Age <= 5 Mth 329 Geri Respite – Invalid Comb 334 Hosp Generated DRG Not = PRS/2 DRG 411 Adm Wt < 1000g, No Matching Dx Code 412 Adm Wt is 1000-2499g, No Matching Dx Code 413 Adm Wt > 6000g, No Matching Dx Code 454 Incompat Fields for Interim Care 467 Adm Wt <1000g, LOS < 28 Days, Sep Mode ≠ T or D 534 Invalid Adm Weight


Related items Section 3: Admission Date on, and Date of Birth.

Section 4: Business Rules (tabular) Account Class: Geriatric Respite and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).


Monitor the Admission Weight of patients <1 year of age. Weight is an important indicator of pregnancy outcome, is a major risk factor for neonatal morbidity and mortality and is required to analyse peri natal services for high-risk infants.

To enable accurate grouping in DRG systems.


Funding & Information Policy Branch (Hospital & Health Service Performance, Department of Health).

Collection start

1993-94

Definition source Department of Health


Barthel Index Score on Admission (a)

Barthel Index Score on Separation (b)

Specification Definition (a) Barthel Index Score, as assessed on admission.

(b) Barthel Index Score, as assessed on separation.

Data type

Numeric Form Score

Field size 3 Layout NNN or spaces.

Right justified with leading zeros.

Location

Sub-Acute Record

Reported by

Public hospitals.

Reported for Care Types F, E, 2, 6, 7, 9 and K. For Care Types P and 8, report spaces.


Code set Report a score in the range 000-100, using the following table:


Barthel Index

Can do without aids

Can do with aids

Can do with help of someone else

Cannot do at all

Self Care Index

Drinking from a cup 4 2 0 0

Eating 6 3 0 0

Dressing upper body 5 5 3 0

Dressing lower body 5 5 2 0

Putting on brace or artificial limb 0 0 -2 0 (if not applicable)

Grooming 5 5 0 0

Washing or bathing 4 4 0 0

Controlling urination 10 10 5 (accidents)

0

Controlling bowel movements 10 10 5 (accidents)

0

Care of perineum/ clothes at toilet 4 4 2 0

Mobility Index

Getting in and out of chair 15 15 7 0

Getting on and off toilet 6 5 3 0

Getting in and out of shower/bath 1 1 0 0

Walking 50 yards on the level 15 15 10 0

Walking up/down one flight of stairs 10 10 5 0

If not walking

Propelling or pushing wheelchair 15 5 0 0

TOTAL (out of 100)


Reporting guide Assessment of Barthel Indexes is required at admission and separation for all S4 Records (excluding Palliative Care).

Statistical separations: • From episodes with Care Types F, E, 2, 6, 7, K or 9 to episodes with Care

Types F, E, 2, 6, 7, K or 9: Separation Barthel of the prior episode may be repeated as the Admission Barthel of the subsequent episode.

• From episodes with Care Types F or E to episodes with Care Types F or E: Admission Barthel of prior episode may be repeated as both the Separation Barthel of the prior episode and the Admission Barthel of the subsequent episode.

The Barthel Index on Admission should be assessed within 48 hours of admission. The Barthel Index on Separation should be assessed on the day on which the decision is taken to cease the Care Type.

The Barthel Index on Separation for patients who die in hospital is 000.

Edits (a) 251 Invalid Adm Barthel

258 Sub-Acute: No Sub-Acute Record 291 Adm Barthel > Sep Barthel 298 Adm Barthel Present 407 Rehab Level 2 or 3 W Low Adm Barth 454 Incompat Fields for Interim Care 620 Adm Barthel/Functional Assessment Date/Care Type mismatch

(b) 252 Invalid Sep Barthel 258 Sub-Acute: No Sub-Acute Record 288 Sep Barthel & Sep Mode Incompatible 291 Adm Barthel > Sep Barthel 292 Sep Barthel Present 454 Incompat Fields for Interim Care 621 Sep Barthel/Functional Assessment Date/Care Type mismatch

Related items Section 3:

• Functional Assessment Date on Admission • Functional Assessment Date on Separation

Section 4: Business Rules (tabular), Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation, and Care Type: Interim Care Program (F and E).


care.

Principal data users Continuing Care and Clinical Service Development (Hospital & Health Service Performance, Department of Health)


Definition source Department of Health Code set source Barthel Index


Campus Code

Specification Definition Indicates the hospital campus where the episode of care was provided. Patient

activity must be reported under the campus code at which it occurred.

Data type Numeric Form Code

Field size 4 Layout NNNN


Reported by All Victorian hospitals (public and private.)



Code set Refer to Section 9: Hospital Code Table

Reporting guide The Hospital Code plus the Site Identifier. The Site Identifier for single campus

hospitals is 0.

Edits 330 Invalid Campus Code

420 Contract/Spoke = Campus Code 472 Pall Care, not approved for Palliative Care Program 473 Care Type 9, not approved for GEM 475 Care Type F or E, not approved for Interim Care 477 Funding Arrangement 5, not approved for Rural Patients Initiative 478 Funding Arrangement 6, not approved for ESAS 520 Accom Type 7, not approved for Medi-hotel 521 Accom Type M, no registered MAPU 522 Accom Type S, no registered SOU 523 CCU Hrs, no Approved CCU 526 ICU Hrs, not approved ICU or NICU 630 Contract/Spoke Identifier cannot be reported for this campus 631 Care Type P not approved for Paediatric Rehabilitation 628 Cannot report for this campus

Related items

Section 2: Campus, and Hospital.

Section 9: Hospital Code Table.

Administration Purpose To identify the specific campus of a hospital providing this episode of care, for

use in policy and planning development.

Principal data users Funding & Information Policy (Hospital & Health Service Performance, Department of Health).


Definition source Department of Health Code set source Department of Health


Carer Availability

Specification Definition A record of whether a person, such as a family member, friend or neighbour has

been identified as providing regular on-going care or assistance, not linked to a formal service.

Data type

Numeric Form Code

Field size

1 Layout N or space

Location

Episode Record


Private hospitals: Report a space in this field.

Reported for Admitted episodes with a Care Type of 1, P, 2, 6, 7, K, 8, 9, F, or E.

For all other Care Types, report a space in this field.



1 Carer not needed/not applicable 2 Lives alone, has a carer 3 Lives alone, has no carer 4 Lives with another, has no carer 5 Lives with another, has a resident carer 6 Lives with another, has a non-resident carer 7 Lives in a mutually dependent situation 8 Missing or not recorded

Reporting Guide Support provided by a carer excludes (for VAED purposes) formal services such

as delivered meals or home help, persons arranged by formal services such as volunteers, and funded group housing or similar services.

Availability infers carer willingness and ability to undertake the caring role and can apply when there are several carers. Where a potential carer is not prepared to undertake the role, or when their capacity to carry out necessary tasks is minimal, then the patient must be reported as not having an informal carer.

Where there are several carers, a decision should be taken as to which of these is the main or primary carer and report accordingly.


1 Carer not needed/not applicable

Person able to self care and/or their therapeutic regime does not require the input of an informal carer, or reporting in this field is not applicable because this is a statistical separation, or the patient has been transferred to another hospital, left against medical advice or died.

Includes:

• Those circumstances where it may be inappropriate for a carer at home to undertake a complex medical procedure requiring a high level of nursing skill.

• Person who is discharged to supported accommodation or other care facility that will provide the formal care required.

Excludes:

• Circumstances where a relative or friend is available but is unwilling or unable to undertake a carer role (report 3 or 4).

• Children under eight years of age (report 4, 5 or 6), unless the patient has been statistically separated, transferred to another hospital, left against medical advice or died.

2 Lives alone, has a carer

Person lives alone and has an informal carer who is able and willing to attend to the person’s recuperative needs on an ongoing basis.

3 Lives alone, has no carer

Person lives alone and does not have an informal carer willing and/or able to visit for the purpose of assisting with care on an arranged and regular basis.

4 Lives with another, has no carer

Person does not live alone but the co-resident/s is/are unable or unwilling to provide the care needed and there is no other external informal carer available.

5 Lives with another, has a resident carer

Household where the person lives with another who is willing and able to provide the care required for recuperation.

Excludes:

Person whose potential co-resident carer is mutually dependent (7).

6 Lives with another, has a non-resident carer

Person does not live alone but the co-resident/s is/are unable and/or unwilling to provide the care needed, but there is an external informal carer who is willing and able to provide this care.

7 Lives in a mutually dependent situation

Households where the service recipient and another person are mutually dependent. The critical aspect of such households is that if either member becomes unavailable for any reason, the other is either at high risk or unable to remain at home.


8 Missing or not recorded

Insufficient information to determine Carer Availability.

Edits 108 Field(s) Missing From Sep 390 Incompat Care Type, Carer Avail, Age and Sep Mode 421 Not Separated; Carer Avail Present 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 591 Invalid Carer Availability 599 Carer Availability Not Required

Related items

Section 3: Separation Mode.

Section 4: Business Rules (tabular) Age, Care Type, Carer Availability and Separation Mode, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative, and Funding Arrangement: Private Hospital Elective Surgery Initiative.

Administration Purpose To enable monitoring of the impact of Carer Availability on separation timing and

use of ambulatory services, to support policy development and planning.

Principal data users Continuing Care and Clinical Service Development (Hospital & Health Service Performance, Department of Health).


Definition source NHDD Code set source

NHDD (Department of Health modified)


Care Type

Specification Definition The nature of the clinical service provided to an admitted patient during an

episode of care.

Data type


Field size

2 Layout AA or NN or NA

Left justified, trailing spaces.

Location

Episode Record





Code Descriptor

F Interim Care Program – Nursing Home Type E Interim Care Program 1 NHT/Non-Acute P Designated Paediatric Rehabilitation Program/Unit 2 Designated Rehabilitation Program/Unit: Level 1 6 Designated Rehabilitation Program/Unit: Level 2 7 Designated Rehabilitation Program/Unit: Level 3 K Non-Designated Rehabilitation Program/Unit 8 Palliative Care Program 5x Approved Mental Health Service or Psychogeriatric Program:

5T – Mental Health Nursing Home Type 5E – Mental Health Secure Extended Care Unit (SECU) 5K – Child and Adolescent Mental Health Service (CAMHS) 5G – Acute, Aged Persons Mental Health Service (APMH) 5S – Acute, Specialist Mental Health Service 5A – Acute, Adult Mental Health Service

9 Geriatric Evaluation and Management Program 0 Alcohol and Drug Program 4 Other care (Acute) including Qualified newborn U Unqualified newborn

Reporting guide Care Type reported should reflect the treatment the patient receives, not the

location of the bed in the facility.


F Interim Care Program —Nursing Home Type

Use this Care Type only for a patient admitted to a unit designated to provide Interim Care and who has been classified as NHT.

NHT

Defined in section 3 of Commonwealth Health Insurance Act: after 35 days continuous hospitalisation (with a maximum break of seven consecutive days), the patient is classified as a NHT patient unless a medical practitioner certifies that the patient is in need of acute care.

Such a patient will have been assessed by an Aged Care Assessment Service and will hold an Aged Care Client Record (ACCR) (formerly ‘2624 certificate’).

Private hospitals: Do not use code F.

Excludes:

• NHT/Non-Acute (1) • Approved Mental Health Service or Psychogeriatric Program Mental Health

Nursing Home Type (5T).

E Interim Care Program

Use this Care Type only for a patient admitted to a unit designated to provide Interim Care and who has not been classified as NHT.

Such a patient will have been assessed by an Aged Care Assessment Service and will hold an Aged Care Client Record (ACCR) (formerly ‘2624 certificate’) before 35 days of continuous hospitalisation.

Private hospitals: Do not use code E.

1 NHT/Non-Acute

This Care Type occurs after an admitted patient has been designated NHT or Non-Acute:

NHT

Defined in section 3 of Commonwealth Health Insurance Act: after 35 days continuous hospitalisation (with a maximum break of seven consecutive days), the patient is classified as a NHT patient unless a medical practitioner provides certification documented in the medical record that the patient is in need of acute care.

Non-Acute

The patient has been in one or more hospitals (public and private) for a continuous period of more than 35 days (with a maximum break of seven consecutive days). If this patient had not been a compensable/ineligible patient, they would be deemed to be a Non-Acute patient.

Such a patient may or may not have been assessed by an Aged Care Assessment Team and may or may not have an approved Aged Care Client Record (ACCR) (formerly ‘2624 certificate’).

Excludes:

• Interim Care Program – Nursing Home Type (F) • Approved Mental Health Service or Psychogeriatric Program Mental Health

Nursing Home Type (5T).


P Designated Paediatric Rehabilitation Program/Unit

A patient who is admitted to, or transferred to, a designated Paediatric Rehabilitation Program/Unit. Use code P only if the public hospital’s Health Service Agreement and/or Statement of Priorities specifies that the hospital has such a designated unit.

Private hospitals: Do not use code P.

2 Designated Rehabilitation Program/Unit: Level 1

A patient who is admitted to, or transferred to, a designated Rehabilitation Program/Unit Level 1. Use code 2 only if:

• The public hospital’s Health Service Agreement and/or Statement of Priorities specifies that the hospital has such a designated unit.

• The rehabilitation episode directly follows the acute care episode in which the principal diagnosis is a spinal cord injury or head injury, or an amputation has been performed.

Private hospitals: Do not use code 2.


A patient who is admitted to, or transferred to, a designated Rehabilitation Program/Unit Level 2. Use code 6 only if the public hospital’s Health Service Agreement and/or Statement of Priorities specifies that the hospital has such a designated unit.

Private hospitals: Use code 6 only if registered under the Health Services Act 1988 to provide this category of care.


A patient who is admitted to, or transferred to, a designated Rehabilitation Program/Unit Level 3. Use code 7 only if the public hospital’s Health Service Agreement and/or Statement of Priorities specifies that the hospital has such a designated unit.


K Non-Designated Rehabilitation Program/Unit

A patient who is admitted to, or transferred to, a non-designated Rehabilitation Program/Unit or admitted to a Restorative Care Program. Use code K only if the public hospital has approval from the Sub-Acute Program to run this program. The combination of Care Type K plus Program Identifier 03 identifies patients admitted to a Restorative Care Program.

Private hospitals: Do not use code K.

8 Palliative Care Program

Applies to a patient who is admitted or transferred to a designated Palliative Care Program/Unit.

Private hospitals: If the hospital operates a similar program and wishes to identify episodes of care using code 8, they may.


5x Approved Mental Health Service or Psychogeriatric Program

A patient who is admitted to, or transferred to, an approved Mental Health Service or Psychogeriatric Program. Use code 5x only if the public hospital’s Health Service Agreement and/or Statement of Priorities specify that the hospital has such an approved Mental Health Service or Psychogeriatric Program.

Private hospitals: Use code 5x only if registered under the Health Services Act 1988 to provide this category of care.

5T Mental Health Nursing Home Type

This Care Type occurs after an admitted patient has been designated NHT or Non-Acute:

NHT

Defined in section 3 of Commonwealth Health Insurance Act: after 35 days continuous hospitalisation (with a maximum break of seven consecutive days), the patient is classified as a NHT patient unless a medical practitioner certifies that the patient is in need of acute care.

Such a patient may or may not have been assessed by an Aged Psychiatric Assessment and Treatment Team (APATT) or an Aged Care Assessment Service (ACAS) and may or may not have an approved Aged Care Client Record (ACCC) (formerly 2624 certificate).

Excludes:

• Interim Care Program – Nursing Home Type (F) • NHT/Non-Acute (1).

5E Mental Health Secure Extended Care Unit (SECU)

This Care Type occurs when a patient is admitted to an approved unit designed to accommodate persons who require active clinical care in the secure/safe environment of a locked ward, often with the intention of longer term (extended) care.

Excludes:

• Mental Health Nursing Home Type (5T) • Community Care Units (CCU) including Vahland CCU • Aged Person’s Mental Health Nursing Homes (APMHNH) • Psychogeriatric Nursing Homes (PGNH)

5K Child and Adolescent Mental Health Service (CAMHS)

A patient who is admitted to an approved CAMHS unit.

5G Acute, Aged Persons Mental Health Service (APMH)

A patient who is admitted to an approved APMH (Psychogeriatric) unit.

Excludes:

• Aged Person’s Mental Health Nursing Home (APMHNH) • Psychogeriatric Nursing Home (PGNH)


5S Acute, Specialist Mental Health Service

A patient who is admitted to an approved Specialist Mental Health Service.

Includes:

• Brain Disorder Unit • Eating Disorders Unit • Forensic Unit • Mother and Baby Unit • Neurological Unit

Excludes: Child and Adolescent Mental Health Service (5K)

5A Acute, Adult Mental Health Service

A patient who is admitted to an approved Adult Mental Health Service.

Excludes:

• Community Care Units (Residential) • Mental Health Nursing Home Type (5T)

9 Geriatric Evaluation and Management Program

A patient who is admitted to, or transferred, to a Geriatric Evaluation and Management Program. Use code 9 only if the public hospital’s Health Service Agreement and/or Statement of Priorities specify that the hospital has a Geriatric Evaluation and Management Program, or the hospital is approved to provide GEM Level 1. This program excludes Nursing Home Type/Non-Acute patients.

Private hospitals: If the hospital operates a similar program and wishes to identify episodes of care using code 9, they may.

0 Alcohol and Drug Program

A patient who is admitted to an Alcohol and Drug Program. Use code 0 only if the patient receives treatment by a specialist physician for an alcohol or drug related condition that is the principal diagnosis. Report this Care Type on admission but not for a change of Care Type following another episode of care.

Private hospitals: Use if the hospital operates a similar program and wishes to identify episodes of care as such.

4 Other (Acute) Care including Qualified newborn

Other types of patient:

Includes:

• Same day and acute (except mental health). • Same day ECT episodes. • Acute episodes in which an ECT has been performed but the care is not

principally mental health. • Geriatric respite care. • Newborn who has been a Qualified newborn for some or all of the duration

of this episode.


Excludes:

• Patients admitted to designated units and programs covered by other Care Types.

• Newborn who has been an Unqualified newborn for the entire duration of this stay (U).

U Unqualified newborn

A newborn who has been an Unqualified newborn for the entire duration of this episode.

Excludes: A newborn who has had any period as a Qualified newborn during this episode (4).

Additional Notes:

Newborns

In a single episode, a newborn may change between being Qualified and Unqualified with such changes being recorded in the (Status Segment) Qualification Status field. Care Type may need updating if a newborn changes from being Unqualified to Qualified.

Refer to Sections 2 and 4: Newborn.

All other episodes

For all other episodes, if the Care Type changes during the episode, the date of that change must be reported in the Separation Date field and other Separation Status details completed; then a new Episode Record must be started (that is, a statistical separation and a statistical admission).

For example:

• If the patient is admitted to Acute care (Care Type 4) but later is transferred to an Approved Mental Health Service, the Care Type changes to Care Type 5x, therefore the earlier Episode Record should be completed and a new Episode Record should be started.

• If the patient is admitted to one of the acute Care Types and after 35 days is deemed to require only NHT care (Care Type F, 1 or 5T), the earlier Episode Record should be completed and a new Episode Record should be started.

There are some circumstances when a patient cannot change between Care Types, for example, a patient cannot move between levels of rehabilitation. Further information on changes of Care Type is provided in Sections 2 and 4: Episode of Care.

A new Episode Record requires Diagnosis and Procedure Codes specific to that episode and therefore a separate DRG identified. The Separation Mode in the earlier Episode Record indicates the episode is being completed not because the patient has gone home, died or been transferred but because the Care Type has changed. The Admission Source of the new Episode Record indicates the new episode is starting not because the patient has been formally admitted but because the Care Type has changed.


Edits 094 Combination A/C Accom Care Med Suff 107 Invalid Care Type 122 Sameday Adm Source/Sep Mode Mismatch 222 Unqual Newborn; Adm Date Not Birth 235 Adm Criterion is N But Care Not 4 250 Deleted – Episode is Sub-Acute 251 Invalid Adm Barthel 252 Invalid Sep Barthel 253 Rehab: Invalid Clin Sub-Prog 254 Rehab: Invalid Adm/Re-Adm to Rehab 255 Rehab: Invalid Onset Date 258 Sub- Acute: No Sub – Acute Record 260 Invalid Care For Qual 261 Newborn Care But Age > 9 Days 262 Invalid Care Type For Newborn 268 Inv Comb Legal, Care & PFS 285 Sub-Acute Record not required 288 Sep Barthel & Sep Mode Incompatible 289 Adm Sce T’fer & Onset = Adm Date 290 Stat Adm Sc & Onset = Adm Date 291 Adm Barthel > Sep Barthel 292 Sep Barthel Present 293 Clin Sub-Prog Present 294 Onset Date Present 295 Adm/Readmit to Rehab Present 297 Sep Rug ADL & Sep Mode Incompatible 298 Adm Barthel Present 303 Pall Care But Invalid Adm Rug ADL 304 Pall Care But Invalid Sep Rug ADL 305 Adm Rug ADL Present 306 Sep Rug ADL Present 329 Geri Respite – Invalid Comb 340 Invalid Source Refer to Pal Care 341 Source Refer to Pal Care Present 390 Incompat Care Type, Carer Avail, Age and Sep Mode 405 Inapplic Clin Prog For Care Type 2 406 Rehab Care Type W/Out Rehab PDX 407 Rehab Level 2 or 3 W Low Adm Barthel 421 Not Separated; Carer Avail Present 437 NIV Duration for Unqual Newborn 447 Unqual Newborn; Age at Sep 448 ICU Stay but Care Type not Acute 453 Wrong PDx for Interim Care 454 Incompat Fields for Interim Care 455 Inconsist Newborn Transferred/Unqual Data 461 ACAS Status not Required 463 Accom Type 4, Care Type invalid 464 Accom Type 7, not Care Type 4 468 Care Type ≠ 1 or F of 5T, LOS >365 Days 471 Care Type 5x, not usual Sep Referral 472 Pall Care, not approved for Palliative Care Program 473 Care Type 9, not approved for GEM 474 Care Type E, LOS > 35 Days


475 Care Type F or E, not approved for Interim Care 488 Incompat Care Type/Adm Source Statistical 489 Incompat Care Type/Sep Mode Statistical 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 498 Pall Care without Pall care Diag 502 Stat Episode: Care Type same as Next Episode 503 Stat Episode: Care Type same as Prior Episode 506 Stat Episode: Rehab also in Next Episode 507 Stat Episode: Rehab also in Prior Episode 532 Account Class MA: not 4, 5E, 5K, 5G, 5S, 5A or U 533 ACAS Status Code Required 535 Care Type 5E, not approved for SECU 536 Care Type 5T, not approved for NHT 537 Care Type 5K, not approved for CAMHS 538 Care Type 5G, not approved for Aged Acute 539 Care Type 5S, not approved for Specialist Acute 540 Care Type 5A, not approved for Adult Acute 541 Care Type K, not approved for Non-Desig Rehab

542 MH Acute Adult Care Type But Age < 14 Years 543 MH Acute Adult Care Type But Age > 65 Years 544 MH APMHS Care Type But Age < 55 Years 545 MH CAMHS Care Type But Age < 5 Years 546 MH CAMHS Care Type But Age > 19 Years 547 MH SECU Care Type But Age < 14 Years 548 MH Specialist Acute Care Type But Age < 14 Years 575 Care Type 5x, MHSWPI Blank 578* MHSWPI Present, not Care Type 5x 586 Care Type 2, not approved for Rehab Lvl 1 587 Care Type 6, not approved for Rehab Lvl 2 588 Care Type 7, not approved for Rehab Lvl 3 596 Same Day ECT: Not in Care Type 4 597 Mental Health Episode: Sep Mode = S 598 Same Day Rehabilitation: Not in Scope 599 Carer Availability Not Required 620 Adm Barthel/Functional Assessment Date/Care Type mismatch 621 Sep Barthel/Functional Assessment Date/Care Type mismatch 626 Invalid Combination for Funding Arrangement PHESI 631 Care Type P, not approved for Paediatric Rehabilitation 660 Care Type not equal to 5x, LOS = Same day, Procedure Code 93341- xx MHSWPI mismatch 661 Care Type not equal to 5x, Non same day, Procedure Code 93341-xx MHSWPI mismatch

Related items

Section 2:

Acute Care, Admission, Admitted Patient, Episode of Admitted Patient Care, Geriatric Evaluation and Management Program, Interim Care Program, Newborns, Nursing Home Type/Non-Acute Care, Palliative Care, Rehabilitation Care and Sub-Acute Care.

Section 4:

• Business Rules (non-tabular) Episode of Care, Newborn Reporting and Palliative Care Reporting.

• Business Rules (tabular) Account Class, Acc Type, Care Type and Medicare



Section 9:

Supplementary Code Lists: Care Type Care Type 2: Rehabilitation Program: Level 1, and Care Type 5A: Mental Health Service and Psychogeriatric Program – Acute, Adult Mental Health Service, and Care Type 5E: Mental Health Service and Psychogeriatric Program – Mental Health Secure Extended Care Unit (SECU), and Care Type 5G: Mental Health Service and Psychogeriatric Program – Acute, Aged Persons Mental Health Service (APMH), and Care Type 5K: Mental Health Service and Psychogeriatric Program – Child and Adolescent Mental Health Service (CAMHS), and Care Type 5S: Mental Health Service and Psychogeriatric Program – Acute, Specialist Mental Health Service, and Care Type 5T: Mental Health Service and Psychogeriatric Program – Mental Health Nursing Home Type, and Care Type 6: Rehabilitation Program: Level 2, and Care Type 7: Rehabilitation Program: Level 3, and Care Type 8 and Care Type 9: Geriatric Evaluation and Management (GEM) Program, and Care Type F and E: Interim Care Program, and Care Type K: Non-Designated Rehabilitation Program/Unit, and Care Type P: Designated Paediatric Rehabilitation.

Administration Purpose To distinguish various types of care in order to:

• Apply the appropriate funding formula to the episode. • Group episodes to facilitate analysis.

Principal data users Funding & Information Policy (Hospital & Health Service Performance, DH).

Continuing Care and Clinical Service Development (Hospital & Health Service Performance, Department of Health).





Clinical Sub-Program

Specification Definition The diagnosis, based on the body system manifesting the reason for

rehabilitation.

Data type

Numeric Form Code

Field size 3 Layout NNN

Right justify, leading zero.



Reported for Optional if Care Type = 2, 6, 7, K, P and Impairment present.

Mandatory if Care Type = 2, 6, 7, K, P and Impairment NOT present

For Care Types 8, 9, F and E, report spaces.



010 Stroke 020 Head Injury Neurological

031 Multiple sclerosis 032 Parkinsonism 033 Polyneuropathy 034 Guillain-Barre 039 Other neurological Spinal Cord

041 Paraplegia incomplete 042 Paraplegia complete 043 Quadriplegia incomplete C1-4 044 Quadriplegia incomplete C5-8 045 Quadriplegia complete C1-4 046 Quadriplegia complete C5-8 049 Other spinal cord Amputation of Limb

051 Upper extremity above elbow Includes: shoulder disarticulation

052 Upper extremity below elbow Includes: • hand and or finger(s) alone • double upper extremity of finger(s) alone

053 Single lower extremity above knee Includes: hip disarticulation

054 Single lower extremity below knee Includes: foot and/or toe(s) alone

055 Double lower extremity above knee Includes: hip(s) disarticulation


056 Double lower extremity above/ below knee Includes: • hip disarticulation • feet and/or toes alone

057 Double lower extremity below knee Includes: feet and/or toes alone

059 Multiple limbs Includes: • lower and upper extremities • double shoulder disarticulation • double upper extremities, includes both hands but excludes if only

fingers of both hands [052] Arthritis

061 Rheumatoid 062 Osteoarthritis 069 Other arthritis Pain

071 Neck pain 072 Back pain 073 Extremity pain 079 Other pain Orthopaedic

081 Post hip fracture 082 Post femur (shaft) fracture 083 Post pelvic fracture 084 Post major multiple fracture 085 Post hip replacement 086 Post knee replacement 089 Other orthopaedic 090 Cardiac Pulmonary

101 Chronic obstructive pulmonary disease 109 Other pulmonary 110 Burns 120 Musculoskeletal Major Multiple Trauma

131 Brain and spinal cord 132 Brain and multiple fracture/amputation 133 Spinal cord and multiple fracture/amputation 139 Other major multiple trauma 140 Other Disabling Impairment 150 Other Geriatric Management

Reporting guide Clinical Sub-Program should be assigned by the treating clinician. Sub-program

assignment must be supported by the appropriate ICD-10-AM codes reported in the X4/Y4 Diagnosis/Extra Diagnosis Records.

Either Clinical Sub-Program or Impairment must be reported for Care Types P, 2, 6, 7 and K.


Edits 253 Rehab Invalid Clin Sub-Prog 258 Sub-Acute: No Sub-Acute Record 293 Clin Sub-Prog Present 405 Inapplic Clin Prog For Care Type 2 454 Incompat Fields for Interim Care

Related items

Section 2: Rehabilitation Care.

Section 4: Business Rules (tabular) Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation, and Care Type: Interim Care Program (F and E).


care.

Principal data users Continuing Care and Clinical Service Development (Hospital & Health Service Performance, Department of Health).





Contract Leave Days Financial Year-to-Date

Specification Definition The number of days during this episode of care that the patient was out of

hospital on ‘contract leave’ in the financial year being reported (includes the month being reported).

Data type


Field size

2 Layout NN or spaces

Right justified and zero filled.

Location

Episode Record

Reported by Victorian public and private hospitals involved in contracted care arrangements with other hospitals (purchases and providers of contracted care).

All other sites, report spaces in this field.

Reported for Episodes where:

• Funding Arrangement is 1 Contract and • Contract Type is 2 Contract Type ABA, 3 Contract Type AB or 5 Contract

Type BA and • Contract Role A Hospital A.

Contract leave is not reported where a patient goes on contract leave and returns on the same day.

Reported when This field can be reported during the patient’s stay and must be present when

the Separation Date is reported in the Episode Record.

Code set A valid number equal to or greater than month-to-date contract leave days.

The minimum valid number is 01. If there are no Contract Leave Days to report, transmit spaces, not zeros.

Reporting guide Contacted Leave Days are included in Patient Days.

The method of calculating Contract Leave Days is consistent with method of calculating leave with or without permission days.

Contract Leave Days Financial Year-to-Date must be equal to or greater than Contracted Leave Days Month-to-Date and equal to or less than Contract Leave Days Total.

Edits 278 Contract Lve YTD Not Num/Blank

282 Contract Lve YTD < MTD 284 Contract Lve Total < YTD 456 Contract Leave, No Contract


Related items

Section 2: Contracted Care, Leave With Permission, Leave Without Permission and Patient Day.

Section 3:

Contract Leave Days Month-to-Date,

Contract Leave Days Total, Patient Days Financial Year-to-Date, Patient Days Month-to-Date, and Patient Days Total.

Section 4:

• Business Rules (non-tabular) Contracted Care and Length of Stay. • Business Rules (tabular) Contracting: Contract Fields, Contract Leave and

Funding Arrangement, and Contracting: Funding Arrangement and Contract Fields.

Administration Purpose To identify days (in this financial year to date) a patient was on contract leave

from this hospital (not on leave with or without permission).


Funding & Information Policy (Hospital & Health Service Performance, Department of Health).

Collection start

1996-97

Definition source Department of Health


Contract Leave Days Month-to-Date


hospital on ‘contract leave’ in the month being reported (month-to-date).

Data type


Field size 2 Layout NN or spaces




All other sites, report a space in this field.







Code set A valid number less than or equal to the number of month-to-date patient days.



Method of calculating Contract Leave Days is consistent with method of calculating leave with or without permission days.

Contract Leave Days Month-to-Date must be equal to or less than Contracted Leave Days Financial Year-to-Date and Contract Leave Days Total.

Edits 277 Contract Lve MTD Not num/blank

282 Contract Lve YTD < MTD 283 Contract Lve Total < MTD 456 Contract Leave, No Contract


Related items


Section 3:

Contract Leave Days Financial Year-to-Date,

Contract Leave Days Total, Patient Days Financial Year-to-Date, Patient Days Month-to-Date and Patient Days Total.

Section 4:

• Business Rules (non-tabular) Contracted Care and Leave. • Business Rules (tabular) Contracting: Contract Fields, Contract Leave and


Administration Purpose To identify days (in this month to date) that a patient was on contract leave from

this hospital (not on leave with or without permission).



Collection start

1996-97




Contract Leave Days Total

Specification Definition The total number of days during this episode of care that the patient was out of

hospital on ‘contract leave’, including days from the previous financial year(s).

Data type


Field size

2 Layout NN or spaces


Location

Episode Record









Code set A valid number equal to or greater than financial year-to-date contract leave

days.



Method of calculating Contract Leave Days is consistent with method of calculating leave with or without permission days.

Contract Leave Days Total must be equal to or greater than Contracted Leave Days Month-to-Date and Contract Leave Days Year-to-Date.

Edits 279 Contract Lve Total Not num/Blank

283 Contract Lve Total < MTD 284 Contract Lve Total < YTD 456 Contract Leave, No Contract


Related items


Section 3:

Contract Leave Days Financial Year-to-Date,

Contract Leave Days Month-to-Date, Patient Days Financial Year-to-Date, Patient Days Month-to-Date, and Patient Days Total.

Section 4:

• Business Rules (non-tabular) Contracted Care and Length of Stay. • Business Rules (tabular) Contracting: Contract Fields, Contract Leave and


Administration Purpose To identify the total days that a patient was on contract leave from this hospital

(not on leave with or without permission).



Collection start

1996-97




Contract Role

Specification Definition Identifies whether the hospital is the purchaser of hospital care (contracting

hospital) or the provider of an admitted or non-admitted service (contracted hospital).

Data type

Alpha Form Code

Field size

1 Layout A or space.

Location

Episode Record



Reported for Episodes where Funding Arrangement is 1 Contract.

If Funding Arrangement is not 1, report a space in this field.

Reported when This field can be reported during the patient’s stay and must be present when the Separation Date is reported in the Episode Record.


A Hospital A (purchasing hospital)

B Hospital B (service provider hospital)

Reporting guide A Hospital A (purchasing hospital)

This hospital is the contracting (purchasing) hospital.

B Hospital B (service provider hospital)

This hospital is the contracted (service provider) hospital.

Edits 408 Contract Role ‘A’ W/Out Proc Flag

409 Proc Flag W/Out Contract Role ‘A’ 410 Illegal Comb Fund Arrange & Contract 418 Invalid Contract Role 423 Invalid Comb Fund Arrange, Contract/Transfer 456 Contract Leave, No Contract

Related items

Section 2: Contracted Care, Leave Without Permission and Leave - Contract.

Section 4:

• Business Rules (non-tabular) Contracted Care and Leave. • Business Rules (tabular) Contracting: Contract Fields, Contract Leave and

Funding Arrangement, and Contracting: Funding Arrangement and Contract


Fields, and Contracting: Funding Arrangement, Contract Type, Contract Role with Admission Source and Separation Mode.

Administration Purpose To identify the role that the reporting hospital has taken in this contract

arrangement (purchaser or provider):

• To make a public hospital casemix payment to the contracting hospital. • To avoid counting the same episode twice (for epidemiological and planning

purposes).



Collection start

1999-00


NHDD


Contract/Spoke Identifier

Specification Definition This field identifies:

• The public or private hospital or day procedure centre involved in contracted care arrangements with this hospital (as purchaser or provider of contracted care).

• The Spoke hospital in a Hub and Spoke arrangement for this episode (the Spoke hospital does not report the episode unless it is a multi-day stay).

• The exact nature of the contract involving an external purchaser. • A non-hospital contracted to provide Interim Care services

Data type

Numeric Form Code

Field size


Location

Episode Record



Reported for This item is mandatory if Funding Arrangement is:

1 Contract or 2 Hub/Spoke Otherwise, report a space in this field.



Code set Where the Funding Arrangement is 1 Contract, report the relevant Hospital

Campus Code (refer to Section 9: Hospital Code Table), which identifies the other party to the contracted service arrangement, with the following exception:

When the Funding Arrangement is 1 Contract and the Contract Type 1 Contract Type B or 7 Contract Type (A), report the code from the list below that identifies the external purchaser/program relevant to the episode of care.

Where the Funding Arrangement is 2 Hub/Spoke, report the relevant Contract/Spoke Identifier or Campus Code from the list below.

Code Descriptor

0010 Melbourne Health Same Day ECT – Northern 0011 Melbourne Health Same Day ECT - Sunshine 0012 Melbourne Health Same Day ECT - Broadmeadows 0030

0050 Other Funding Source Interim Care Program: Residential aged care facility

0070 Interim Care Program: Supported accommodation


0100 Australian Health Care Agreement (AHCA) - Elective Surgery 0200 Department of Health: HIV AIDS 0300 Department of Veterans’ Affairs: Veterans’ Cardiac Agreement 0311 Brunswick Dialysis Unit 0312 Coburg Dialysis Unit 0313 Broadmeadows Dialysis Unit 0314 Williamstown Dialysis Unit 0315 Sunshine Hospital Dialysis Unit 0316 Northern Hospital Dialysis Unit 0317

0318 Craigieburn Health Service St George’s Dialysis

0321 Caulfield General Medical Centre Dialysis Unit 0331 Austin Training Satellite Dialysis Unit 0332 Heidelberg Repatriation Hospital Dialysis Unit 0333 North East Kidney Service 0334 Epping Dialysis Unit 0351 Newcomb Dialysis Unit 0352 Rotary House Dialysis Unit 0353 South Geelong Renal Unit 0361 Maroondah Hospital Dialysis Unit 0362 Spring Street Dialysis Unit 0400 Individual contracts with international patients 0500 Transport Accident Commission: Alfred Road Trauma Unit 0600 Department of Health: Rural & Remote Health Agency Program 0700 Department of Health: Bowen Centre - ARMC 0710 Department of Health: Interim Payment 0800 Victorian Maintenance Dialysis Program 0900 St Jude Pacemaker Replacement Program 0910 St Vincent’s Lithotripsy Service - Bendigo Hospital 0920 St Vincent’s Lithotripsy Service - MMC Clayton 0930 St Vincent’s Lithotripsy Service - RCH 0940 St Vincent’s Lithotripsy Service - MMC Moorabbin 0950 St Vincent’s Lithotripsy Service - West Gippsland Healthcare Group 0960 St Vincent’s Lithotripsy Service - Ballarat Hospital 0970 St Vincent’s Lithotripsy Service - Geelong Hospital 0980 St Vincent’s Lithotripsy Service - Frankston Hospital 0990 St Vincent’s Lithotripsy Service - Goulburn Valley Health

Reporting guide Codes 0050 and 0070 Interim Care Program shall only be used with Contract

Type 7 Contract Type (A).

0070 Interim Care Program: Supported Accommodation

Includes:

Supported Residential Service (SRS)

Edits 410 Illegal Comb Fund Arrange & Contract

419 Invalid Contract/Spoke Identifier 420 Contract/Spoke = Campus/Site 456 Contract Leave, No Contract 630 Contract/Spoke Identifier cannot be reported for this campus (Currently inactive)


Related items

Section 2: Contracted Care, Leave – Contract, Leave Without Permission and Hub and Spoke.

Section 4:

• Business Rules (non-tabular) Contracted Care and Hub and Spoke • Business Rules (tabular) Contracting: Contract Fields, Contract Leave and


Administration Purpose To enable monitoring of health services provided under contract in Victoria.

Principal data users Funding & Information Policy (Hospital & Health Service Performance,

Department of Health).





Contract Type

Specification Definition

Describes the contract arrangement between the contractor and the contracted hospital/facility. Contract Types are distinguished by the physical movement of the patient between the contracting (where applicable) and contracted hospitals.

Data type

Numeric Form Code

Field size

1 Layout N or space.

Location

Episode Record

Reported by Victorian public and private hospitals involved in contracted care arrangements (purchases and providers of contracted care).


Reported for Episodes where the Funding Arrangement is 1 Contract. For all other episodes,

report a space in this field.

Reported when This field can be reported during the patient’s stay and must be present when the Separation Date is reported in the Episode Record.


1 Contract Type B 2 Contract Type ABA 3 Contract Type AB 4 Contract Type (A)B 5 Contract Type BA 6 Contract Type A(B) 7 Contract Type (A)

Reporting guide The contracting (purchasing) hospital (or authority) is termed Hospital A.

The contracted (service provider) hospital is termed Hospital B.

Contract Types are described by the sequence of the A and B characters, representing the movement of the patient between the contracting and contracted entities. Brackets indicate the patient was not physically present in one of either the contracting or contracted hospital. For example, (A) means the patient was not physically present in the contracting hospital.

1 Contract Type B

A (health authority/other external purchaser) contracts B (hospital) for admitted service.


2 Contract Type ABA

Patient admitted by Hospital A. Hospital A contracts Hospital B for admitted or non-admitted patient service. Patient returns to Hospital A on completion of service by Hospital B.

3 Contract Type AB

Patient admitted by Hospital A. Hospital A contracts Hospital B for admitted or non-admitted patient service. Patient does not return to Hospital A on completion of service by Hospital B.

4 Contract Type (A)B

Patient is not present in the Contracting Hospital (A) at any time during the episode.

Hospital A contracts Hospital B for the whole admitted patient service.

An (A)B contract type cannot occur between two public hospitals unless approved by the Hospital & Health Service Performance Division of the Department of Health. Where two public hospitals enter into a contract, the contracting hospital must provide care or treatment for the patient as part of the overall service provided (Contract Types ABA, AB and BA).

5 Contract Type BA

Hospital A contracts Hospital B for an admitted patient service following which the patient moves to Hospital A for the remainder of the care.

6 Contract Type A(B)

Hospital A contracts Hospital B for the whole admitted patient service. Hospital B provides the service at Hospital A. Patient is not present in the Contracted Hospital (B) at any time during the episode.

An A(B) contract type cannot occur between two public hospitals unless approved by the Hospital & Health Service Performance Division of the department. Where two public hospitals enter into a contract, the contracting hospital must admit and provide care or treatment for the patient as part of the overall service provided (Contract Types ABA, AB and BA).

7 Contract Type (A)

Hospital A contracts a residential aged care facility or supported accommodation to provide Interim Care. Patient not present in the Contracting Hospital (A) for some or any time during the episode.

Edits 410 Illegal Comb Fund Arrange & Contract 417 Invalid Contract Type 423 Invalid Comb Fund/Contract/Transfer 454 Incompat Fields for Interim Care 456 Contract Leave, No Contract

Related items

Section 2: Contracted Care, Leave – Contract and Leave Without Permission.


Section 4:

• Business Rules (non-tabular) Contracted Care • Business Rules (tabular) Care Type: Interim Care Program (F and E), and

Contracting: Contract Fields, Contract Leave and Funding Arrangement, and Contracting: Funding Arrangement and Contract Fields, and Contracting: Funding Arrangement, Contract Type and Contract Role with Admission Source and Separation Mode.

Administration Purpose To identify the type of contract arrangement (if any) that applies to this episode,

to make a link (if appropriate) to the record reported by the other party to the contract arrangement.


Funding & Information Policy (Hospital & Health Service Performance, DH).

Collection start

1999-00


NHDD


Country of Birth (SACC code set)

Specification Definition The country in which the person was born as represented by a code.

Data type

Numeric Form Code

Field size

4 Layout NNNN

Location

Episode Record




Code set Refer to Section 9: Supplementary Code Lists.

Reporting guide Report the country in which the patient was born, not the country of residence.

Edits 036 Invalid Country of Birth

069 Newborn From Overseas 228 Unusual Birth Place 234 Aboriginal/Ts Islander But Not Aust Born 392 Recip HCA Account, Not O/Seas Born 571 Acct Recip, Pcode Oseas, Locality not RHCA 574 Postcode Overseas, Locality RHCA, Acct not RHCA

Related items

Section 9:

Supplementary Code Lists Country of Birth

Administration Purpose To facilitate epidemiological studies.



Definition source NHDD SACC Country of

Birth, Version 2.03 – Department of Health modified

Code set source



Criterion for Admission

Specification Definition The criterion which has been met to justify the patient’s admission.

Data type

Alpha Form Code

Field size

1 Layout A

Location

Episode Record




Code set Criteria for Admission Decision Chart

Code Descriptor

N Qualified newborn U Unqualified newborn O Patient expected to require hospitalisation for minimum of one night B Day-only Automatically Admitted Procedures E Day-only Extended Medical Treatment C Day-only Not Automatically Qualified Procedures S Secondary family member

Reporting guide Refer to Section 1: Publications and Contact Details Relevant to PRS/2 and the

VAED for the website link to the Private Health Insurance (Benefits Requirements) Rules 2008.

The original Criterion for Admission must not be changed, even where a patient's condition requires a different course than that planned at admission. For example, a newborn who changes Qualification Status must retain their original Criterion for Admission code (N or U), and Criterion O is not altered if the patient dies, is transferred or is discharged on the same day.

N Qualified newborn

Any newborn who is: Admitted within the first nine days of life to facilities approved by the Commonwealth Minister for the provision of special care in designated neonatal intensive care units and designated special care nurseries, or • Is the second or subsequent live born of a multiple birth, or • Admitted to or remains in hospital without their mother. That is, the mother

must be unable to provide adequate care for the baby before this criterion can be applied. The admitted status of the mother is irrelevant.


U Unqualified newborn

Any newborn who, at time of admission, does not meet any of the criteria for admission as a Qualified newborn (N).

O Patient expected to require hospitalisation for minimum of one night

The patient is expected to require overnight or multi-day hospitalisation. Type O should be used where there is an expectation that the patient will require ongoing admitted care.

Type O includes: • Patients who present to the Emergency Department, but die within a few

hours, despite intensive resuscitative treatment but whose treatment plan initially included an expectation that they would require hospitalisation for a minimum of one night

• Patients who are transferred to another hospital where the intention is that they will require hospitalisation for a minimum of one night, having received active treatment and stabilisation at the original hospital.

Type O excludes: • Patients whose treatment is expected to be concluded on the same day • Patients whose care is provided over more than one date (for example, a

patient presenting at 11pm and departing at 2am), but for whom the intention is not for ongoing overnight care.

Examples: • A patient arrives at the hospital with multiple injuries resulting from a car

accident and receives emergency stabilisation prior to transfer to another hospital. The first hospital reports an admitted patient, with Criteria for Admission O.

• A patient presents with a headache and baseline observations deteriorate over time. Following diagnosis, the patient is transferred to another facility for treatment. The first hospital reports an admitted patient, with Criteria for Admission O.

B Day-only Automatically Admitted Procedures

In order to meet Criterion for Admission B, it must be the intention that the patient will:

• Receive at least one procedure listed on the Automatically Admitted Procedure List; AND

• Receive treatment on a day-only basis. A patient who is not intended to receive an Automatically Admitted Procedure cannot meet Criterion for Admission Type B.

The Automatically Admitted Procedure List is available at www.health.vic.gov.au/hdss

Where a patient is expected to require treatment on an overnight or multi-day stay basis while receiving an Automatically Admitted Procedure, they should be admitted as Criterion for Admission Type O.

Same day IV therapy is included as a Type B procedure, but non therapeutic IV administration is excluded (for example, administration of contrast for radiological procedures). Placement of an IV cannula alone, or injection via an IV cannula, does not warrant admission.


http://www.health.vic.gov.au/hdss

E Extended Medical Treatment

Criteria for Admission E should be used where patients receive a minimum of four hours of continuous active management consisting of:

• Regular observations (which may include diagnostic or investigative procedures); OR

• Continuous monitoring.

When determining a patient’s eligibility for admission as Criteria for Admission E, the following factors could be taken into account:

Regular observations may include:

• Observations of vital or neurological signs provided on a repeated and periodic basis during the patient’s treatment

• Provision of repeated and periodic diagnostic or investigative procedures, or provision of treatment.

Hospitals are encouraged to develop local policies or guidelines as to what constitutes regular observations. These guidelines should be consistent with established clinical pathways, protocols or accepted clinical practice.

Continuous monitoring could include:

• Continual monitoring via ECG or similar technologies. (Note: continual blood pressure and/or pulse monitoring is not considered a sufficient level of continual monitoring for these purposes).

• Continuous active supervision or treatment by clinical staff.

Type E excludes:

• Patient has been provided with clinical intervention/s for their condition and requires time to rest prior to discharge home

• Patient has a length of stay of more than four hours, primarily consisting of waiting for results of diagnostic tests

• Patient has been present at the hospital for more than four hours, but has not been engaged in treatment or diagnosis.

Non-admitted (emergency or outpatient) services provided to a patient who is subsequently classified as an admitted patient shall be regarded as part of the admitted episode.

When a patient is transferred from the Emergency Department to a ward (including short stay units), the Admission Time is the time treatment was started in the Emergency Department rather than the time it was decided to transfer the patient. Any intervention provided after treatment commences should be recorded and identified as part of the admitted patient’s episode of care.

Admission for Day-only Extended Medical Treatment. The patient’s medical record must contain clinical documentation that indicates the treatment provided to the patient justified admission, and that continuous active management exceeded four hours.

Includes: Patients undergoing a Type C Professional Attention Procedure where it is intended that they will also receive Extended Medical Treatment.


C Day-only Not Automatically Qualified Procedures

The Not Automatically Qualified for Admission List identifies procedures that would normally be undertaken on a non-admitted basis and therefore not normally accepted as admissions in their own right.

In order to meet Criterion for Admission C, a patient must: • Receive a procedure on the Not Automatically Qualified for Admission List;

and • Be intended to be treated on a day-only basis; and • The treating doctor must provide evidence that the patient’s special

circumstances justify admission for the purpose of having this procedure. This evidence must be documented in the patient’s medical record.

Audits of medical records may be conducted for the purpose of ensuring that treatment of such patients in an admitted patient setting is warranted.

A patient who does not undergo a procedure listed on the Not Automatically Qualified for Admission List cannot meet Criterion for Admission C.

The Not Automatically Qualified for Admission List is available at www.health.vic.gov.au/hdss

A patient who is intended to receive a procedure on the Not Automatically Qualified for Admission List as part of an overnight or multi-day stay should be admitted as Criterion for Admission O.

S Secondary Family Member

A person who does not meet any of the Criteria for Admission categories but is accompanying a patient who is admitted. Code S must be used for all such persons.

Only Early Parenting Centres can report this category.

Edits 072 Invalid Criterion for Adm 074 Invalid Age For Criterion 235 Adm Crit N But Care Not 4 308 Adm Crit O But Int’d Same Day 309 Adm Crit B & Int’d Overnight 310 Adm Crit C Int’d Overnight 311 Adm Crit N & Int’d Same Day 312 Adm Crit U Int’d Same Day 328 Early Parenting Centre -Invalid comb 329 Geri Respite - Invalid Comb 336 Invalid Comb For Crit Care Transfer 454 Incompat Fields for Interim Care 455 Inconsist Newborn Transferred/Unqual Data 482 Incompat Adm Source/Crit for Adm 484 Incompat Adm Type/Crit for Adm 486 Incompat Age/Crit for Adm 490 Incompat Crit For Adm/Qual Stat 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 549 Type B Crit for Adm, LOS >1 550 Type C Crit for Adm, LOS >1 551 Type C Crit for Adm, LOS >4 hrs 552 Type E Crit for Adm, LOS >1 553 Type E Crit for Adm, LOS <4 hrs


http://www.health.vic.gov.au/hdss

Related items

Victorian Hospital Admission Policy: http://www.health.vic.gov.au/hdss/vaed/index.htm

Section 2: Criterion for Admission, Neonate, Newborn, and Overnight or Multi-day Stay.

Section 4:

• Business Rules (non-tabular) Contracted Care • Business Rules (tabular) Account Class: Geriatric Respite, and Admission

Source and Criterion For Admission, and Admission Type and Criterion For Admission, and Age and Criterion For Admission, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission and Newborn Qualification Status (1st Status Segment), and Criterion for Admission and Qualification Status, and Criterion for Admission: Secondary Family Member, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative, and Funding Arrangement: Private Hospital Elective Surgery Initiative, and Newborns: Criteria for Admission, Qualification Status, Care Type.

Administration Purpose To prompt the hospital to consider the eligibility of the patient for admission, to

identify:

• Any patient admitted for procedures listed on Automatically Admitted Procedure List

• Any patient with special circumstances requiring admission (rather than treatment as an ambulatory patient).

• Any person treated in an Early Parenting Centre not meeting the requirements to be admitted (to omit such episodes from reporting to the Commonwealth).



Collection start

1993-94

Definition source Commonwealth Code set source

Department Health


http://www.health.vic.gov.au/hdss/vaed/index.htm

Date of Accident

Specification Definition The date of the transport accident causing the person to require hospitalisation.

Data type

Numeric Form Date

Field size

8 Layout DDMMYYYY

Location

DVA and TAC Record


Reported for Episodes with an Account Class of TAC (T-).


Code set Episodes with an Account Class of DVA (V-): blank.

Episodes with an Account Class of TAC (T-): A valid date.

Reporting guide For all episodes with an Account Class of TAC (T-), Date of Accident must not be blank.

For the majority of episodes with an Account Class of TAC (T-), Date of Accident should not be:

• Later than the Admission Date • Prior to the Date of Birth • Report unknown Date of Accident as 01011901

Edits 444 Invalid Date of Accident 445 Dt of Accid Incompat W TAC Claim Nbr – Fatal 446 Dt of Accid Incompat W TAC Claim Nbr - Warning 554 Date of Accident > Admission Date 555 Date of Accident < Date of Birth

Related items Section 3: Account Class.

Administration Purpose To enable TAC payment of relevant episodes of care. Date of Accident is used

in the matching process to link hospital admissions to TAC claims.

These data are held separately to other VAED data to ensure that personal information remains confidential.


Transport Accident Commission

Collection start

2002—03

Definition source TAC


Date of Birth

Specification Definition The date of birth of the person.

Data type

Numeric Form Date

Field size

8 Layout DDMMYYYY

Location

Episode Record




Code set A valid date.

Reporting guide The Date of Birth must be on or before Date of Admission.

Year (YYYY) can only be 18xx, 19xx or 20xx.

If the Date of Birth is unknown or has been estimated, the appropriate value should be reported in the Date of Birth Accuracy field.

Edits 035 Invalid Date of Birth

057 Incompat Adm Type/Age 061 Married – Age Not Within Range 069 Newborn From Overseas 074 Invalid Age For Criterion 080 Sex Indeterminate Age > 90 127 Nil Value DRG 160 AR-DRG Grouper GST Code> Zero 186 Neonate MDC But Age>= 28 Days 187 Adm Weight Too Low 188 Adm Wt Too High 189 Age < 1 Year But Adm Weight Missing 190 Adm Wt Present But Not Aged < 1 Year 215 Sex Indeterminate But Age >= 90 Days 222 Unqual Newborn; Adm Date Not Birth 226 Adm Date Before Date of Birth 227 Age Calculated As 120 Yrs & Over 240 Newborn Accom But Over 4 Months 245 Adm Wt >= 9kg But Age is <= 5 Mth 255 Rehab: Invalid Onset Date 261 Newborn Care Type But Age > 9 Days 262 Invalid Care Type For Newborn 329 Geri Respite - Invalid comb 353 Code & Age Incompatible 390 Incompat Care Type, Carer Avail, Age and Sep Mode


397 Sep Referral Postnatal, Incompatible Age/Sex 431 Newborn But Not Newborn Accom 447 Unqual Newborn; Age at Sep > 10 Days 461 ACAS Status not Required 467 Adm Wt <1000g, LOS < 28 Days, Sep Mode ≠ T or D 479 Incompat Adm Source/Age 480 Incompat Adm Source/Age <15 481 Incompat Adm Source/Age <55 486 Incompat Age/Crit for Adm 487 Incompat Age/Qual Stat 493 Incompat Sep Mode/Age <15 494 Incompat Sep Mode/Age <55 518 Medicare Code = 0, Age > 6 Months 519 Medicare Code = 0, Age > 12 Months 533 ACAS Status Code Required 542 MH Acute Adult Care Type But Age < 14 Years 543 MH Acute Adult Care Type But Age > 65 Years 544 MH APMHS Care Type But Age < 55 Years 545 MH CAMHS Care Type But Age < 5 Years 546 MH CAMHS Care Type But Age > 19 Years 547 MH SECU Care Type But Age < 14 Years 548 MH Specialist Acute Care Type But Age < 14 Years 555 Date of Accident < Date of Birth 579 MHSWPI Valid, no Matching DOB 602 Newborn Accom but Over 12 Months 640 DOB Accuracy and DOB mismatch

Related items

Section 2: Age.

Section 3:

Admission Date, Date of Birth Accuracy.

Section 4: Business Rules (tabular) Admission Source and Age, and Admission Type and Age, and Age and Criterion For Admission, and Age and Qualification Status, and Age, Care Type, Carer Availability and Separation Mode.


• Enable calculation of ‘age at admission’ (difference between Date of Birth and Admission Date) that is used in the allocation of DRGs and for analysis of service utilisation, need for services and epidemiological studies.

• Verify other fields (such as diagnosis and procedure codes) for consistency with calculated age.



Collection start

1979-80



Date of Birth Accuracy

Specification Definition A code representing the accuracy of the components of a date - day, month, year.

Data type

Alpha Form Structured Code

Field size

3 Layout AAA

Location

Episode Record

Reported by All Victorian Health Services (public and private).


Reported when The episode record is reported.

Value domain This data element’s value domain consists of a combination of three codes, each of

which denotes the accuracy of one date component:

Code Descriptor

A The referred date component is accurate E The referred date component is not known but is estimated U The referred date component is not known and not estimated.

This data element contains three positional components (DMY) that reflect the order

of the date components in the format (DDMMYYYY) of the reported Date of Birth.

Component Descriptor 1st – D Refers to the accuracy of the day component. 2nd – M Refers to the accuracy of the month component 3rd - Y Refers to the accuracy of the year component

Reporting guide Any combination of the values A, E, U representing the corresponding level of

accuracy of each date component of the reported date.

Where possible, report the accuracy of each date component. However, where software systems allow the collection of a binary value for Date of Birth Accuracy (that is the system has an ‘Estimated Date of Birth’ check box or similar) values such as ‘AAA’ and ‘EEE’ will be acceptable.

It is understood that the Date of Birth Accuracy Code will be reported as ‘AAA’ unless the date has been flagged as an estimated date. It is not necessary to validate the Date of Birth provided by every patient unless there is a reasonable suspicion that the date provided is not correct. Where there is a question over the date provided, or where the patient is unable or unwilling to provide their date of birth, the date should be estimated and flagged as such.


If the date of birth is provided by a reliable source (for example the patient or close relative) and is known as accurate then the date accuracy indicator should be reported as ‘AAA’.

If the patient’s approximate age is known, then the Date of Birth should be estimated using the approximate age to calculate an estimated year of birth. Sentinel dates should not be used. The Date of Birth Accuracy code would be reported as ‘UUE’, that is the day and month are ‘unknown’ and the year is ‘estimated’.

A Year component value of U – Unknown is not acceptable.

Where the date part is accurate or estimated, the date part cannot be ‘00’. Where the date part is unknown, the date part may be ‘00’ or ‘NN’.

Examples: Valid combinations include:

DOB Accuracy = ‘AAA’, DOB = ‘03/11/1956’ DOB Accuracy = ‘EEE’, DOB = ‘03/11/1956’

DOB Accuracy = ‘UUE’, DOB = ‘00/00/1945’

DOB Accuracy = ‘UUE’, DOB = ‘01/01/1945’

Invalid combinations include:

DOB Accuracy = ‘AAA’, DOB = ‘00/00/1956’

DOB Accuracy = ‘AAA’, DOB = ‘00/06/1956’

DOB Accuracy = ‘EEE’, DOB = ‘00/00/1956’

DOB Accuracy = ‘UUE’, DOB = ‘00/00/0000’ DOB Accuracy = ‘UEE’, DOB = ‘00/00/1956’

Edits 639 Invalid Date of Birth Accuracy code

640 DOB Accuracy and DOB mismatch

Related items

Section 2: Age Section 3: Date of Birth

Administration Purpose Required to derive age for demographic analyses and for analysis by age at a point

of time.


Multiple internal and external research users.

Collection Start 2008-09

Definition source NHDD (Department of Health modified)

Value Domain source

NHDD 294429


Diagnosis Codes

Specification Definition At least one (principal diagnosis) and up to 40 ICD-10-AM (Seventh Edition)

codes reflecting injuries, disease conditions, patient characteristics and circumstances impacting this episode of care.

Data type


Field size 8 (x 40) Layout AANNNNspacespace

Left justify, with trailing spaces.

Location Diagnosis Record (12) Extra Diagnosis Record (28)




Code set Department of Health ICD-10-AM Library File 2011-1, available at:

http://www.health.vic.gov.au/hdss/reffiles/index.htm

Reporting guide Report diagnoses in accordance with Australian Coding Standards and the Victorian Additions to Australian Coding Standards. The Victorian Additions to Australian Coding Standards are available at:

http://www.health.vic.gov.au/hdss/icdcoding/vicadditions/index.htm

Omit punctuation as shown in ICD-10-AM books (that is, no dot or oblique in codes): for example, ICD-10-AM diagnosis code A00.0 Cholera due to Vibrio cholerae 01, biovar cholerae must be entered as A000.

When a code is shown in ICD-10-AM with a symbol (dagger or asterisk), omit the symbol when transmitting to PRS/2.

The first character of the field is the prefix: P, A, C or M (see below for more

information).

In the first diagnosis code field:

• Character 1 must be P. • Next five characters must contain an alpha/numeric code of three, four or five

characters (with trailing spaces if required). • Characters 7 and 8 must be spaces.

For the remaining thirty nine diagnosis code fields, if a code is present:

• Character 1 must be P, A, C or M. • Next six characters must contain an alpha/numeric code of three, four, five or

six characters (with trailing spaces if required). • Character 8 must be a space.




Morphology codes (where first character is M) Submit without punctuation (oblique) and with M prefix: for example MM80703

Prefixes: Definitions for P, A, C, M All diagnosis codes require a prefix. Prefixes indicate whether the condition was present on, or arose during admission, and also denote morphology codes. DH will map prefixes to the NHDD Condition Onset Flag in order to report to the Commonwealth.

Refer to the Victorian Additions to the Australian Coding Standards, available at: http://www.health.vic.gov.au/hdss/icdcoding/vicadditions/index.htm

Effect of prefix A A secondary function of the A prefix is to suppress the code description appearing in data extracts provided to TAC and on DRG statements generated by PRS/2 for Work Cover Patients.

Edits 127 Nil Value DRG

160 AR-DRG Grouper GST Code > Zero 186 Neonate MDC But Age >= 28 Days 195 Blank X4 197 Embedded Blank Diag Oper 231 P - Diag Not Prefixed By P 329 Geri Respite - Invalid comb 334 Hosp Generated DRG Not = PRS/2 DRG 351 Illegal Code Format 352 Code Not Found On Code File 353 Code & Age Incompatible 354 Code & Sex Incompatible 355 Invalid Principal Diag - Rejection 355 Invalid Principal Diag - Warning 358 Area Code Restraint 361 External Cause Code Missing 362 Morphology Code Missing 363 External Cause needs Place Code 364 External Cause/Activity Code Mismatch 403 Qual Newborn W/Out Justificat 406 Rehab Type W/Out Rehab PDx 411 Adm Wt < 1000g, No Matching Dx Code 412 Adm Wt 1000-2499g, No Matching Dx Code 413 Adm Wt > 6000g, No Matching Dx Code 426 Y4 Not Accompanied by X4 428 X4 Upd not Accompanied by Y4 Upd 442 NIV Duration for Healthy Newborn 447 Unqual Newborn; Age at Sep > 10 Days 450 Code Incompatible W Female Sex 451 Code Incompat W Male Sex 452 Place/Activity W/Out External Cause Code 453 Wrong PDx for Interim Care 454 Incompat Fields for Interim Care 498 Pall Care without Pall care Diag 525 Diagnosis Code Indicates Boarder Episode 559 Prefix = P, Unusual Code Combination 560 Prefix = P, Unusual Code Combination 561 Prefix = C, Unusual Code Combination



562 Prefix = C, Unusual Code Combination 563 Prefix = A, Unusual Code Combination 564 Prefix = A, Unusual Code Combination 590 Diag Prefix M, Not Morph Code 595 Neoplasm Code Missing 600 Invalid Code 601 Sequencing Error

Related items

Section 2: DRG Classification and Principal Diagnosis.

Section 3: Hospital Generated DRG.

Section 4: Business Rules (tabular) Account Class: Geriatric Respite, and Care Type: Interim Care Program (F and E).


• Facilitate epidemiological studies and other research. • Identify episodes containing specified codes for co-payments. • Facilitate grouping for casemix purposes.


Collection start

1979-80


ICD-10-AM Seventh Edition


Duration of Mechanical Ventilation in ICU

Specification Definition Total duration of Mechanical Ventilation (MV) in hours provided in an approved

Intensive Care Unit (ICU) or Neonatal Intensive Care (NICU) during this episode of care.

Data type


Field size 4 Layout NNNN or spaces.

Right-justified and zero-filled.

Location Diagnosis Record

Reported by Public and private hospitals with an approved ICU or NICU, as listed in Section 9, and hospitals contracting with a hospital with an approved ICU.

Otherwise, report spaces.

Reported for Episodes where MV is provided in such an ICU or NICU. Otherwise, report

spaces.


Code set A number in the range 0001 to 9999.

Reporting guide If the patient has more than one period of MV in ICU during this episode, the

total duration of all such periods is reported.

Duration is reported in hours, rounded up. Only MV hours provided in an ICU are counted:

• Where a patient is intubated and MV starts in an operating theatre, for the purposes of the Duration of MV field, the counting of the duration of MV commences when the patient enters the ICU.

• It is not necessary to stop the MV clock when a ventilated patient is transferred from the ICU to theatre and back; instead the intervening hours will count towards the total MV hours.

• Where a patient receives MV in a combined ICU/CCU, report the ICU/CCU hours in the ICU field, not the CCU field.

Refer to ACS 1006 Ventilatory support.

Duration of MV is edited against Duration of Stay in ICU.

A patient who receives MV in an ICU in Hospital B during a contracted service episode has the duration of that MV reported by Hospital B; Hospital A also reports the MV hours received in Hospital B in addition to any MV hours the patient received in an ICU at Hospital A.

Note: Duration of MV is not passed to the grouper; the grouper uses the duration from the ACHI ventilation procedure code.


Edits 317 Invalid MV Duration 318 MV Duration >ICU Stay 319 MV Duration But No ICU Stay 320 MV Duration But No Proc Code 323 MV Duration >Total Stay 325 Incompat MV Hrs, A/C Class 328 Early Parenting Centre – Invalid Comb 454 Incompat Fields for Interim Care 641 MV Hours with Incorrect Procedure Code

Related items

Section 2: Intensive Care Unit and Time of Death.

Section 3:

Duration of Stay in Intensive Care Unit.

Section 4: Business Rules (tabular) Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member.

Administration Purpose To facilitate a co-payment on specified DRGs. MV hours represent a sound and

clinically valid surrogate for illness severity.



Collection start

1996-97


-


Duration of Non-invasive Ventilation (NIV) in ICU

Specification Definition Total number of hours of non-invasive ventilatory assistance given via any route

other than intubation or tracheostomy, provided to patients in an approved Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) or Intensive Care Unit (ICU).

By far the most common is Continuous Positive Airway Pressure (CPAP). Duration of the following, less common, methods of ventilatory assistance should also be reported in this field:

• Bi-level Positive Airway Pressure (BiPAP) • Intermittent Positive Pressure Breathing (IPPB), and/or • Intermittent Mandatory Ventilation (IMV)

Data type Numeric Form Quantitative value

Field size


Right justified and zero-filled

Location

Diagnosis Record

Reported by Optional for public and private hospitals providing NIV in an approved Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) or Intensive Care Unit (ICU).


Reported for Episodes of care for patients receiving NIV in a NICU and/or SCN and/or ICU. Otherwise, report spaces.



Reporting guide Respiratory support by intubation and/or tracheostomy If CPAP, BiPAP, IPPB or IMV is performed by intubation or tracheostomy in an ICU or NICU, this duration should be reported in Duration of Mechanical Ventilation in ICU, and not Duration of Non-invasive Ventilation.

Counting duration of NIV All NIV hours given in NICU, SCN and/or ICU are counted.

Reference below to ’24-hour period’ means ‘midnight to midnight’.

• Where the NIV starts in an operating theatre, for the purpose of the Duration of NIV field, the counting of the duration of NIV starts when the patient enters the NICU or SCN or ICU.

• It is not necessary to stop the NIV clock when a ventilated patient is transferred from the ICU to theatre and back; instead the intervening hours will count towards the total NIV hours.

Calculation is in four stages: 1. Counting non-intermittent NIV 2. Counting intermittent NIV 3. Counting Contracted NIV hours (if any) 4. Summing and rounding above calculations


1 Counting non-intermittent NIV If the patient has more than one period of non-intermittent NIV during this episode, sum the duration of all such periods.

2 Counting intermittent NIV

If a patient is electively cycling on and off NIV (usually only for NICU/SCN patients):

• If NIV was given for four or more hours in the 24-hour period between midnight and midnight, count this as 24 hours.

• If NIV was given for less than four hours in the 24-hour period between midnight and midnight, count the actual number of hours.

3 Counting Contracted NIV hours

When a patient receives NIV provided in a NICU, SCN or ICU in Hospital B during a contracted service episode:

• Hospital B reports the duration of NIV calculated according to these rules; • Hospital A also includes the NIV hours received in Hospital B in addition to

any NIV hours the patient received at Hospital A, each calculated according to these rules.

4 Summing and rounding above calculations

Sum the resulting figures for non-intermittent and intermittent NIV (including any Contracted hours). Then round up to the nearest hour.

Refer to ACS 1006 Ventilatory support.

Edits 328 Early Parenting Centre – Invalid Comb

329 Geri Respite – Invalid Comb 435 Invalid NIV Duration 437 NIV Duration for Unqual Newborn 438 NIV Duration > Total Stay 442 NIV Duration for Healthy Newborn 454 Incompat Fields for Interim Care 583 NIV Duration High 644 NIV Hours With Incorrect Procedure Code

Related items


Section 3: Duration of Stay in Intensive Care Unit.

Section 4:

Business Rules (tabular) Account Class: Geriatric Respite, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member.

Administration Purpose To evaluate the need for a co-payment on specified DRGs. Although the

preliminary evaluation has not resulted in a co-payment, this item remains to facilitate further evaluation if deemed necessary.




Collection start

2002-03

Definition source Australian and New Zealand Neonatal Network (amended: in PRS/2, NIV via nasopharyngeal intubation is reported in Duration of MV in ICU field)


Duration of Stay in Cardiac/Coronary Care Unit

Specification Definition Total duration of stay (hours) in an approved Cardiac/Coronary Care Unit (CCU),

during this episode of care.

Data type


Field size



Location

Diagnosis Record

Reported by Public and private hospitals with an approved CCU, as listed in Section 9, and hospitals contracting with a hospital with an approved CCU.


Reported for Episodes where time is spent in such a CCU. Otherwise, report spaces.



Reporting guide If patient has more than one period in CCU during this episode, the total duration

of all such periods is reported.

Duration is reported in hours, rounded up.

Where a hospital has a combined ICU/CCU, the duration of stay is reported in either the ICU field or the CCU field, not both. However, where a patient receives mechanical ventilation or non-invasive ventilation in a combined ICU/CCU, report the ICU/CCU hours in the ICU field, not the CCU field.

A patient admitted to a CCU in Hospital B during a contracted service episode has the duration of that CCU stay reported by Hospital B; Hospital A also reports the hours spent in CCU in Hospital B in addition to any hours spent in CCU at Hospital A.

Where a patient is located in a CCU but does not require the level of care normally provided in a CCU (for example, due to a lack of beds elsewhere), Duration of Stay in CCU must not be reported.

Edits 322 ICU/CCU Stay > Total Stay

328 Early Parenting Centre – Invalid Comb 333 Invalid CCU Stay 454 Incompat Fields for Interim Care 523 CCU Hrs, no Approved CCU 582 CCU Duration High 603 CCU Account Class, No CCU Hours 605 Priv Pt, CCU Hours, No CCU Account Class


Related items

Section 2: Cardiac/Coronary Care Unit and Time of Death. Section 3: Duration of Mechanical Ventilation in ICU, and Duration of Non-invasive Ventilation (NIV). Section 4: Business Rules (tabular) Account Class: Geriatric Respite and Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member.

Administration Purpose To facilitate a co-payment on specified DRGs.



Collection start

1998-99

Definition source DH


Duration of Stay in Intensive Care Unit

Specification Definition Total duration of stay (hours) in an approved Intensive Care Unit (ICU) or

Neonatal Intensive Care Unit (NICU), during this episode of care.

Data type


Field size


Right-justified, zero-filled.

Location

Diagnosis Record

Reported by Public and private hospitals with an approved ICU/NICU, as listed in Section 9, and hospitals contracting with a hospital with an approved ICU.


Reported for Episodes where time is spent in such an ICU/NICU. Otherwise, report spaces.


Code set A valid number in the range 0001 to 9999.

Reporting guide If patient has more than one period in ICU/NICU during this episode, the total

duration of all such periods is reported.

Duration is reported in hours, rounded up. Only the time in the ICU/NICU is counted, not time, for example, in an operating theatre.

Where a hospital has a combined ICU/CCU, the duration of stay is reported in either the ICU field or the CCU field, not both. However, where a patient receives mechanical ventilation or non-invasive ventilation in a combined ICU/CCU, report the ICU/CCU hours in the ICU field, not the CCU field.

A patient admitted to an ICU/NICU in Hospital B during a contracted service episode has the duration of that ICU/NICU stay reported by Hospital B; Hospital A also reports the hours spent in ICU/NICU in Hospital B in addition to any hours spent in ICU/NICU at Hospital A.

Where patient is is located in an NICU/ICU but does not require the level of care normally provided in a NICU/ICU (for example, due to a lack of beds elsewhere), Duration of Stay in ICU must not be reported.


Edits 316 Invalid ICU Duration 318 MV Duration >ICU Stay 319 MV But No ICU Stay 322 ICU/ CCU Stay > Total Stay 324 Incompat ICU Hrs, A/C Class 328 Early Parenting Centre – Invalid Comb 448 ICU Stay but Care Type not Acute 454 Incompat Fields for Interim Care 526 ICU Hrs, no approved ICU or NICU 604 ICU Account Class, No ICU Hours 606 Priv Pt, ICU Hours, No ICU Account Class

Related items


Section 3:

Duration of Mechanical Ventilation in ICU

Section 4:

Business Rules (tabular) Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member.

Administration Purpose To facilitate a co-payment on specified DRGs.



Collection start

1996-97



DVA ID / TAC Claim Number (Where Account Class is V- DVA)

Specification Definition The Department of Veterans’ Affairs file number of the person.

Data type


Field size

9 Layout AAAANNNX or AAAANNNXA

Location

DVA and TAC Record (Shared field DVA ID/TAC Claim Number)


Reported for Episodes with an Account Class of DVA (V-).


Code set Obtained from the DVA card, held by those eligible for DVA benefits.

Layout: Part 1

State identifier. Valid codes: Q, N, V, T, S or W. ACT is included in N (NSW) and NT with S (SA).

Part 2 War Group Code, (Alphanumeric characters) may be up to 3 characters.

Part 3 Serial Number (numeric characters) may be 2 to 6 characters in length.

Reporting guide

Part 4 (optional) Spouse or Dependent Identifier, may be 1 character in length.

Valid format (see also above layout and following examples): • Only alphabetic and numeric characters and spaces are permitted • Alphabetic characters must be in uppercase • A maximum of six numeric characters is permitted • Trailing spaces (to the right) are permitted. • Spaces between characters are not permitted.

Note: VAED does not validate war codes but a list of codes is available at: http://www.health.vic.gov.au/hdss/reffiles/index.htm

Examples of permitted formats: N123456, VX123456, WXX123A, QXXX1B

If a DVA ID / TAC Claim Number that the hospital believes is correct cannot pass these edits, the hospital should refer the problem to their local DVA office.



Edits 180 DVA ID/TAC Claim Number Blank 181 DVA ID/TAC Claim Number Incorrect

Related items Section 3: Account Class.

Administration Purpose To facilitate payment by DVA for DVA patients.


Principal data users Department of Veterans’ Affairs.



source DVA


DVA ID / TAC Claim Number (Where Account Class is T- TAC)

Specification Definition The Transport Accident Commission Claim Number of the person, relating to this

hospital admission.

Data type


Field size

9 Layout YYXXXXX

Location

DVA and TAC Record (Shared field DVA ID/TAC Claim Number)


Reported for Episodes with an Account Class of TAC (T-).


Code set Obtained from the TAC, allocated to those eligible for TAC benefits.

C-U Claim number unavailable should be reported when the person’s TAC claim number is not known by the hospital.

Reporting guide Characters 1-2: Financial year of claim acceptance.

Characters 3-7: Numeric characters allocated by TAC.

Characters 8-9: Spaces Examples of permitted formats: 9812345, 5412345

Hospitals wishing to obtain TAC Claim Numbers can contact TAC on: 1300 654 329 (Choose option 2: Service Provider to a TAC Customer).

Edits 180 DVA ID/TAC Claim Number Blank

181 DVA ID/TAC Claim Number Incorrect 445 Dt of Accid Incompat W TAC Claim Nbr – Fatal 446 Dt of Accid Imcompat W TAC Claim Nbr - Warning

Related items Section 3: Account Class and Date of Accident.

Administration Purpose To facilitate payment by TAC for TAC patients.


Principal data users Transport Accident Commission.

Collection start 2002—03

Definition source TAC Code set source

TAC


FIM Score on Admission (a)

FIM Score on Separation (b)

Specification Definition FIMTM Score, as assessed on admission.

FIMTM Score, as assessed on separation.

Data type

Numeric Form Score

Field size

18 Layout NNNNNNNNNNNNNNNNNN or spaces. Right justified with leading zeros.

Location

Sub-Acute Record

Reported by Public hospitals

Reported for Care Types F, E, 2, 6, 7 and 9. Optional for Care Type K. For Care Type 8, report spaces.


Code set Report a score for each item (i.e. 1 digit score for 18 items):

FIMTM Scores

Score Sequence

Motor Subscale

FIMTM Scores

1 Eating No Helper

2 Grooming 7 = Complete Independence

3 Bathing 6 = Modified Independence

4 Dressing Upper Body Helper

5 Dressing Lower Body 5 = Supervision or setup

6 Toileting 4 = Minimal assistance

7 Bladder Management 3 = Moderate assistance

8 Bowel Management 2 = Maximal assistance

9 Transfers – Bed/Chair/Wheelchair 1 = Total assistance

10 Transfers - Toilet

11 Transfers – Bath/Shower

12 Walk/Wheelchair

13 Stairs

Cognitive Subscale


14 Comprehension

15 Expression

16 Social Interaction

17 Problem Solving

18 Memory

Reporting guide Assessment of FIMTM Scores is required at admission and separation for all S4

Records (excluding Restorative Care and Palliative Care)

Statistical separations:

• From episodes with Care Types F, E, 2, 6, 7, K or 9 to episodes with Care Types F, E, 2, 6, 7, K or 9: Separation FIMTM of the prior episode may be repeated as the Admission FIMTM of the subsequent episode.

• From episodes with Care Types F or E to episodes with Care Types F or E: Admission FIMTM of prior episode may be repeated as both the Separation FIMTM of the prior episode and the Admission FIMTM of the subsequent episode.

The FIMTM on Admission should be assessed within 72 hours of episode start.

The FIMTM on Separation should be assessed within 72 hours prior to episode end.

The FIMTM on Separation for patients who die in hospital is 18 (i.e. a score of 1 for each item).

Edits (a) 645 Invalid Admission FIMTM

(b) 646 Invalid Separation FIMTM (a) 662 Adm FIMTM /Functional Assessment Date/Care Type mismatch (b) 663 Sep FIMTM /Functional Assessment Date/Care Type mismatch Related items Section 3:

• Functional Assessment Date on Admission • Functional Assessment Date on Separation • Barthel Index Score on Admission • Barthel Index Score on Separation

Section 4: Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), Care Type: Designated Paediatric Rehabilitation Program (P), and Care Type: Interim Care Program (F and E)


care. Principal data users Ambulatory & Co-ordinated Care (Wellbeing, Integrated Care & Aged, DH)


Definition source DH Code set source

FIMTM


Functional Assessment Date on Admission (a)

Functional Assessment Date on Separation (b)

Specification Definition Date of functional assessment for assignment of Barthel Index Score on

admission.

Date of functional assessment for assignment of Barthel Index Score on separation

Data type

Numeric Form Date

Field size

8 Layout DDMMYYYY

Location

Sub-Acute Record


Reported for Admitted episodes with Care Types F, E, 2, 6, 7, 9 and K. For Care Types P and

8 report spaces.


Code set Valid Date.

Reporting guide Reported when a Barthel Index Score is reported, for Interim Care,

Rehabilitation and GEM (Care Types F, E, 2, 6, 7, 9 and K).

(a) The Functional Assessment must be performed on or after the date of admission, but should be within 48 hours of admission.

(b) The Functional Assessment must be performed on or before the date of separation, but should be on the day the decision is made to cease the episode. Where a patient dies in hospital, the Functional Assessment Date on Separation may be reported as spaces.

Statistical separations:

• From episodes with Care Types F, E, 2, 6, 7, K or 9 to episodes with Care Types F, E, 2, 6, 7, K or 9: Functional Assessment Date on Separation of the prior episode may be repeated as the Functional Assessment Date on Admission of the subsequent episode.

• From episodes with Care Types F or E to episodes with Care Types F or E (Interim Care NHT to/from Interim Care only): Functional Assessment Date on Admission of the prior episode may be repeated as both the Functional Assessment Date on Separation of the prior episode and the Functional Assessment Date on Admission of the subsequent episode.


Editing of data is carried out on the S4 record. If an E4 Update record is submitted with a Care Type change from F, E, 2, 6, 7, 9 or K to Care Type 1, P, 8, 5x, 0, 4 or U (which does not require Functional Assessment Date on Admission/Separation), the Sub-Acute data will be deleted from the database and a warning edit to this effect will be triggered by the E4 record.

(a) 454 Incompat Fields for Interim Care

618 Invalid Adm Functional Assessment Date 620 Adm Barthel/Functional Assessment Date / Care Type mismatch 622 Functional Assessment Date < 7 days before Adm Date 624 Functional Assessment Date < Adm Date or > 7 days after Adm Date 627 Care Type changed, Sub-Acute data deleted

Edits

(b) 454 Incompat Fields for Interim Care 619 Invalid Sep Functional Assessment Date 621 Sep Barthel/Functional Assessment Date / Care Type mismatch 625 Functional Assessment Date > 7 days after Sep Date 626 Functional Assessment Date > Sep Date or < 3 days before Sep Date 627 Care Type changed, Sub-Acute data deleted

Related items

Section 3:

• Barthel Index Score on Admission • Barthel Index Score on Separation

Section 4:

Business Rules (tabular), Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).

Administration Purpose To support annual reporting obligation under the Australian Health Care

Agreement.

Principal data users Ambulatory & Co-ordinated Care (Wellbeing, Integrated Care & Aged, DH)




Funding Arrangement

Specification Definition Identifies the specific funding arrangement, if any, which applies to this episode

of care.

Data type


Field size

1 Layout N or space

Location

Episode Record

Reported by • Any Victorian public and private hospital involved in contracted care arrangements with another hospital (purchasers and providers of contracted care).

• Any Victorian public and private hospital involved in hub and spoke arrangements with another hospital or satellite site.

• Any Victorian public or private hospital treating a patient identified as a Coordinated Care Trial patient.

• Any Victorian public hospital involved in the Rural Patients Initiative program. • Any Victorian public hospital involved in the Elective Surgery Access Service

program (ESAS). • Any Victorian private hospital involved in the Public/Private Elective Surgery

Initiative (PHESI).

All other circumstances, report a space in this field.

Reported for Episodes where an admitted service is provided under contract, hub and spoke,

Coordinated Care Trial arrangements, Rural Patients Initiative, Elective Surgery Access Service (ESAS) or Private Hospital Elective Surgery Initiative.

Otherwise, report a space in this field.



1 Contract 2 Hub and spoke 4 Coordinated Care Trial 5 Rural Patients Initiative 6 Elective Surgery Access Service 7 Private Hospital Elective Surgery Initiative 8 National Bowel Cancer Screening Program

Reporting guide 1 Contract

Patient receiving contracted hospital care under an agreement between a purchaser of hospital care (contractor) and a provider of an admitted or non-admitted service (contracted hospital).


2 Hub and Spoke Patient receiving a specialist service at another hospital or satellite site (spoke) under a hub and spoke arrangement. This hospital is the hub hospital. (Any service provided at a spoke hospital or satellite site is reported by the hub hospital only.)

4 Coordinated Care Trial

Patient identified as a Coordinated Care Trial patient.

5 Rural Patients Initiative

Admission under the Rural Patients Initiative. Use code 5 only if the public hospital has been allocated resources through the Rural Patients Initiative.


6 Elective Surgery Access Service (ESAS)

Admission under the Elective Surgery Access Service (ESAS). Use code 6 only if the public hospital has been allocated resources through the Elective Surgery Access Service.


7 Private Hospital Elective Surgery Initiative

Admission under the Public/Private Elective Surgery Initiative. Use code 7 only if approved by DH.

Public hospitals: Do not use code 7.

8 National Bowel Cancer Screening Program

Admission under the National Bowel Cancer Screening Program.

All hospitals can use code 8 (both designated and non-designated) for patients admitted under this program.

Edits 108 Field(s) Missing From Sep

410 Illegal Comb Fund Arrang & Contract 416 Invalid Fund Arrangement 423 Invalid Comb Funding/Contract/Transfer 424 Not Separated: Fund Arr S/Be Spaces 454 Incompat Fields for Interim Care 456 Contract Leave, No Contract 477 Funding Arrangement 5, not approved for Rural Patients Initiative 478 Funding Arrangement 6, not approved for ESAS 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 523 CCU Hrs, no Approved CCU 526 ICU Hrs, no approved ICU or NICU 626 Invalid combination for Funding Arrangement PHESI 635 NBCSP but Age < 50 Years 638 Private Hosp, Public Account Without Contract

Related items

Section 2: Contracted Care and Hub and Spoke.

Section 3:


Contract Role,

Contract/Spoke Identifier on page 3-62, and Contract Type.

Section 4:

• Business Rules (non-tabular) Contracted Care and Hub and Spoke. • Business Rules (tabular) Care Type: Designated Rehabilitation Program (2,

6, and 7), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Contracting: Contract Fields, Contract Leave and Funding Arrangement, and Contracting: Funding Arrangement and Contract Fields, and Contracting: Funding Arrangement, Contract Type and Contract Role with Admission Source and Separation Mode, and Funding Arrangement: Elective Surgery Access Service, Funding Arrangement: Rural Patients Initiative and Funding Arrangement: Private Hospital Elective Surgery Initiative.


• Identify whether a specific funding arrangement applies to this episode. • Facilitate health services planning and monitoring.



Definition source DH Code set

source DH


Given Name(s)

Specification Definition The given name/s of the DVA or TAC patient.

Data type

Alphanumeric Form Name

Field size

15 Layout AXXXXXXXXXXXXXX

Location

DVA and TAC Record


Reported for Admitted episodes with an Account Class of V- DVA or T- TAC.


Code set -

Reporting guide The given name/s of the patient.

Permitted characters: A to Z (uppercase), space, apostrophe, and hyphen.

The first character must be an alpha character.

Edits 162 Invalid Given Name

556 Given Name Unusual Length

Related items

Section 3: Account Class and Surname.

Administration Purpose To facilitate payment by DVA and TAC for relevant episodes of care.


Principal data users Department of Veterans’ Affairs and Transport Accident Commission.



source -


Hospital Generated DRG

Specification Definition The DRG generated by the in-house hospital grouper for this episode of care.

Data type


Field size

4 Layout ANNA or NNNA or spaces

Location

Diagnosis Record

Reported by Public and private hospitals - optional. Otherwise, report spaces in this field.

Reporting in this field is recommended for hospital quality control, if the hospital has onsite grouping facilities.

Reported for Any/all admitted episodes of care. Otherwise, report spaces in this field.

Reported when The Separation Date is reported in the Episode Record.

Code set AR-DRG or Vic DRG used by the hospital.

Reporting guide Report the AR-DRG or Vic DRG generated by the hospital for each episode.

This field should be automatically reported for all episodes grouped by the hospital.

Edits 334 Hosp Generated DRG Not = PRS2 DRG

Related items

Section 2: DRG Classification.

Administration Purpose To enable hospitals to detect differences between their grouping processes and

those of DH.


Hospital Health Information Managers.

Collection Start 1 July 1998 Version 6.0


source Commonwealth Department of Health and Aged Care.

Department of Health, Victorian health policy and funding guidelines 2011-2012.


Hospital Insurance Fund

Specification Definition The patient’s hospital insurance fund (if any) regardless of whether the patient

elects to be a public or private patient, or is a compensable or ineligible patient.

Data type


Field size

3 Layout AAA or NNN

Location

Episode Record




Code set Code Descriptor – Registered name (may differ from Trading name)

ACA ACA Health Benefits Fund AMA The Doctors’ Health Fund Ltd AHM Australian Health Management Group AUF Australian Unity Health Limited CBH CBHS Friendly Society CDH Cessnock District Health Benefits Fund CPS CUA Health AHB Defence Health Limited YMH Federation Health GMH Geelong Medical and Hospital Benefits Association Limited GMF Goldfields Medical Fund (Inc.) FAI Grand United Corporate Health Limited GUF Grand United Health Fund Pty Ltd HBF HBF Health Funds Inc HCI Health Care Insurance Ltd HIF Health Insurance Fund of WA SPS Health Partners Inc HHB Healthguard Health Benefits Fund Limited HBA Hospital Benefits Association Limited (see notes) HCF Hospitals Contribution Fund of Australia Ltd, The LHS Latrobe Health Services, Inc. LHM Lysaght Peoplecare MUI Manchester Unity Australia Ltd SGI MBF Health Pty Ltd MPL Medibank Private Limited MBF Medical Benefits Fund of Australia Ltd MDH Mildura District Hospital Fund MCL Mutual Community Ltd (see notes) NMH National Mutual Health Insurance (see notes) NHB Navy Health Ltd NIB NIB Health Funds Limited (see notes)


OMF Onemedifund (National Health Benefits, Pty. Ltd) PWA Phoenix Health Fund Ltd QCH Queensland Country Health Limited QTU Queensland Teachers Union Health Fund Ltd RTE Railway & Transport Health Fund Ltd RBH Reserve Bank Health Society SPE Police Health Limited SLM St Luke's Medical & Hospital Benefits Association Limited NTF Teacher's Federation Health Limited TFS Transport Health Pty Ltd UAD United Ancient Order of Druids Friendly Society Limited UAF United Ancient Order of Druids Registered Friendly Society Grand

Lodge of NSW WDH Western District Health Fund Ltd (Westfund) 996 New Australian hospital insurance fund 997 Non-Australian hospital insurance fund 998 Patient is insured but will not/cannot specify the fund 999 Patient is uninsured/Insurance status unknown

Reporting guide The patient’s hospital insurance fund status should in no way be taken to

indicate her/his election, nor should it influence that election. Hospital Insurance Fund, as reported to the VAED, is not to be used to indicate the source of payment for the patient’s treatment. If a patient is covered by a hospital insurance fund, the code should be recorded regardless of whether the patient plans to utilise the insurance for this admission. This data item is used only to indicate the extent of private health coverage and should not be directly linked to software invoicing systems.

For patients admitted for treatment covered by Department of Veteran Affairs, Transport Accident Commission or Victorian Workcover Authority, record the hospital insurance fund code if the patient holds private hospital insurance, regardless of whether the patient intends to claim against their insurance, or record 996, 997, 998 or 999 as appropriate.

Code 996 New Australian hospital insurance fund should only be used to report a new fund which has not been added to the list of valid codes. It should not be reported when the insurance status of a patient is unknown or where the appropriate code is unknown. Contact the HDSS Helpdesk to determine the correct code to be reported.

When assigning code 999, the appropriate code for Level of Insurance is 4 No hospital insurance or 9 Insurance status unknown, as appropriate.

Notes

• Mutual Community and HBA are owned and operated by BUPA Australia Pty Ltd. ANZ Insurance is issued by BUPA. In Victoria BUPA trades as HBA. In South Australia BUPA trades as Mutual Community Ltd.

• IMAN Australian Health Plans for temporary visa holders are underwritten by NIB

• Overseas Student Health Cover (OSHC) is provided by the following health funds: Australian Health Management; Medibank Private; Lysaght Peoplecare (subcontracting to OSHC Worldcare) and NIB.


Edits 264 Blank /Invalid Hospital Insurance Fund 313 No Fund But Insured 314 Fund But Uninsured 558 New Hospital Insurance Fund

Related items

Section 3: Hospital Insurance Status.

Administration Purpose To monitor patterns of hospital insurance usage to inform health policy and

planning.


Collection start

1996-97


Private Health Insurance Act 2007.

A list of registered health funds and contact details can be found at this website:

http://www.phiac.gov.au/


http://www.phiac.gov.au/

Hospital Insurance Status

Specification Definition The patient’s hospital insurance status, regardless of whether they elect to be a

public or private patient, or are a compensable or ineligible patient.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record





Code Descriptor

2 Hospital Insurance 4 No Hospital Insurance 9 Hospital Insurance Status Unknown

Reporting guide Persons covered by insurance for benefits for ancillary services only are

included in 4 No Hospital Insurance. It cannot be assumed that a mother’s hospital insurance status will apply to her newborn baby. In particular, single insurance cover does not provide for a newborn baby of the policyholder.

Edits 044 Invalid Hospital Insurance Status Code

313 No Fund But Insured 314 Fund But Uninsured

Related items

Section 3: Hospital Insurance Fund.

Administration Purpose To monitor patterns of hospital insurance usage to inform health policy and

planning.


Collection start

1990-91


DH


Impairment

Specification Definition The diagnosis, based on the body system manifesting the reason for

rehabilitation.

Data type

Numeric Form Code

Field size

6 Layout NNNNNN or spaces

Left justified, trailing spaces

Location

Sub-Acute Record


Reported for Optional if Care Type = 2, 6, 7, K, P and Clinical Sub-program present.

Mandatory if Care type = 2, 6, 7, K, P and Clinical Sub-program NOT present. For Care Types 8, 9, F and E, report spaces.



Stroke

011 Left Body Involvement (Right Brain) 012 Right Body Involvement (Left Brain) 013 Bilateral Involvement 014 No Paresis 019 Other stroke Brain Dysfunction

Non-traumatic brain dysfunction 0211 Sub-arachnoid haemorrhage 0212 Anoxic brain damage 0213 Other non-traumatic brain dysfunction Traumatic brain dysfunction 0221 Open injury 0222 Closed injury Neurological Conditions

031 Multiple sclerosis 032 Parkinsonism 033 Polyneuropathy 034 Guillain-Barre Syndrome 035 Cerebral Palsy 038 Neuromuscular disorders (include motor neuron disease) 039 Other neurological disorders Spinal Cord Dysfunction

Non-traumatic spinal cord dysfunction


04111 Paraplegia, incomplete 04112 Paraplegia complete 041211 Quadriplegia incomplete C1-4 041212 Quadriplegia incomplete C5-8 041221 Quadriplegia complete C1-4 041222 Quadriplegia complete C5-8 0413 Other non-traumatic SCI Traumatic spinal cord dysfunction 04211 Paraplegia, incomplete 04212 Paraplegia complete 042211 Quadriplegia incomplete C1-4 042212 Quadriplegia incomplete C5-8 042221 Quadriplegia complete C1-4 042222 Quadriplegia complete C5-8 0423 Other traumatic spinal cord dysfunction Amputation of Limb

051 Single Upper Amputation Above the Elbow 052 Single Upper Amputation Below the Elbow 053 Single Lower Amputation Above the Knee (includes through knee) 054 Single Lower Amputation Below the Knee 055 Double Lower Amputation Above the Knee (includes through knee) 056 Double Lower Amputation Above/below the Knee 057 Double Lower Amputation Below the Knee 058 Partial Foot Amputation (includes single/double) 059 Other Amputation Arthritis

061 Rheumatoid 062 Osteoarthritis 069 Other Arthritis Pain Syndromes

071 Neck pain 072 Back pain 073 Extremity pain 074 Headache (includes migraine) 075 Multi-site pain 079 Other pain (includes abdominal/chest wall) Orthopaedic Conditions

Fracture (includes dislocation, excludes neurological involvement) 08111 Fracture of hip, unilateral (includes #NOF) 08112 Fracture of hip, bilateral (includes #NOF) 0812 Fracture of shaft of femur (excludes femur involving knee joint) 0813 Fracture of pelvis 08141 Fracture of knee (includes patella, femur involving knee joint, tibia or

fibula involving knee joint) 08142 Fracture of lower leg, ankle, foot 0815 Fracture of upper limb (includes hand, fingers, wrist, forearm, arm,

shoulder) 0816 Fracture of spine (excludes where the major disorder is pain)


0817 Fracture of multiple sites (multiple bones of same lower limb, both lower limbs, lower with upper limb, lower limb with rib or sternum Excludes with brain injury or with spinal cord injury)

0819 Other orthopaedic fracture (includes jaw, face, rib, orbit or sites not elsewhere classified)

Post Orthopaedic Surgery (includes secondary to fracture or arthritis)

08211 Unilateral hip replacement 08212 Bilateral hip replacement 08221 Unilateral knee replacement 08222 Bilateral hip replacement 08213 Knee and hip replacement same side 08232 Knee and hip replacement different sides 0824 Shoulder replacement or repair 0825 Post spinal surgery (includes nerve root injury (laminectomy, spinal

fusion, discectomy; excludes spinal cord injury or caudaequina) 0826 Other orthopaedic surgery Cardiac 091 Following recent onset of new cardiac impairment (AMI, heart

transplant, cardiac surgery) 092 Chronic cardiac insufficiency 093 Heart and heart/lung transplant Pulmonary

101 Chronic Obstructive Pulmonary Disease 102 Lung Transplant 109 Other pulmonary Burns

110 Burns Congenital Deformities

121 Spina Bifida 129 Other Congenital Other Disabling Impairments

131 Lymphoedema 132 Other disabling impairments Major Multiple Trauma

141 Brain and spinal cord injury 142 Brain and multiple fracture/amputation 143 Spinal cord and multiple fracture/amputation 149 Other multiple trauma Developmental Disabilities

151 Developmental Disabilities Re-Conditioning/Restorative

161 Re-conditioning following surgery 162 Re-conditioning following medical illness


163 Cancer rehab

Reporting guide Impairment codes should be assigned by the treating clinician. Code assignment must be supported by the appropriate ICD-10-AM codes reported in the X4/Y4 Diagnosis/Extra Diagnosis Records.

The Australian Rehabilitation Outcomes Centre (AROC) provides guidelines for coding Impairments:

http://chsd.uow.edu.au/aroc/dataset.html#impairment Either Clinical Sub-Program or Impairment must be reported for Care Types P, 2, 6, 7 and K.

Edits 253 Rehab Invalid Clin Sub-Prog or Impairment 258 Sub-Acute: No Sub-Acute Record 293 Clin Sub-Prog or Impairment Present 405 Inapplic Clin Prog or Impairment For Care Type 2 454 Incompat Fields for Interim Care

Related items

Section 2: Rehabilitation Care. Section 4: Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type: Designated Paediatric Rehabilitation Program (P)


care.


Ambulatory & Co-ordinated Care (Wellbeing, Integrated Care & Aged, DH).

Collection start

2009-10


DH


http://chsd.uow.edu.au/aroc/documents/aroc_aicv1_coding_guidelines.pdf

Indigenous Status

Specification Definition An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait

Islander descent who identifies as an Aboriginal or Torres Strait Islander and is accepted as such by the community in which he or she lives.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record




Code set Code Descriptor 1 Aboriginal but not Torres Strait Islander origin 2 Torres Strait Islander but not Aboriginal origin 3 Both Aboriginal and Torres Strait Islander origin 4 Neither Aboriginal nor Torres Strait Islander origin 8 Question unable to be asked 9 Patient refused to answer Reporting guide A person of Aboriginal descent is a person descended from the original

inhabitants of Australia.

The Torres Strait Islands are the islands directly to the north of Cape York, between Cape York and Papua New Guinea.

In Victoria, the community of Torres Strait Island people is small and the community of people of Aboriginal and Torres Strait Island people is smaller again, therefore code 2 Indigenous-Torres Strait Islander but not Aboriginal origin and code 3 Indigenous-Aboriginal and Torres Strait Islander origin would not be widely used.

Code 8 Question unable to be asked should only be used under the following circumstances: When the patient’s medical condition prevents the question of Indigenous Status being asked; or

In the case of an unaccompanied child who is too young to be asked their Indigenous Status.

This information must be collected for every admitted patient episode and updated each time the patient represents to the hospital for admission.

Systems must not be set up to input a default code.

Rather than asking every patient about his or her indigenous status, first ask the


patient. “Were you born in Australia?”:

• If No, the patient should be asked, “What country were you born in?” • If Yes, the patient should be asked, “Are you of Aboriginal or Torres Strait

Islander origin?” If the patient answers Yes to being of Aboriginal or Torres Strait Islander origin, then ask further questions to record correctly the person’s indigenous status.

Patient is baby or child The parent or guardian should be asked about the indigenous status of the child. If the mother of a newborn baby has not identified as being of Aboriginal or Torres Strait Islander descent, hospital staff should not assume the baby is non-Aboriginal; the father may be of Aboriginal or Torres Strait Islander descent.

For further information refer to the Principles of recording Aboriginal Status in Victoria, available on the internet at:

http://www.health.vic.gov.au/koori/

Edits 070 Invalid Indigenous Status 234 Aboriginal/Ts Island But Not Aust Born 393 Recip HCA Account, Indig Stat A Or TI 495 Incompat Sep Referral and Indigenous Status 513 Indigenous Status/Preferred Language Mismatch 629 Incompatible Adm Source/Indigenous Status

Related items

Section 2: Country of Birth and Preferred Language.


• Enable planning and service delivery, and monitoring of indigenous health at state and national level

• Facilitate application of specific funding arrangements.

Principal data users Koori Health Unit (Public Health, DH).


Collection start

1987-88


NHDD (DH modified)


http://www.health.vic.gov.au/koori/

Intended Duration of Stay

Specification Definition The intention of the responsible clinician at the time of the patient’s admission to

hospital, to discharge the patient either on the day of admission or a subsequent date.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record





1 Intended same day 2 Intended overnight (or longer)

Reporting guide The intended duration of stay should be ascertained for all admitted patients at

the time the patient is admitted to hospital. This should not be altered after admission, regardless of the actual duration of the episode.

Edits 307 Invalid Intended Duration

308 Adm Crit O But Int’d Same Day 309 Adm Crit B & Int’d Overnight 310 Adm Crit C Int’d Overnight 311 Adm Crit N Int’d Same Day 312 Adm Crit U & Int’d Same Day 329 Geri Respite – Invalid Comb 454 Incompat Fields for Interim Care

Related items

Section 4: Business Rules (tabular) Account Class: Geriatric Respite, and Care Type: Interim Care Program (F and E).

Administration Purpose To provide clinical indicator data.



Collection start

1996-97


NHDD (DH modified)


Intention to Re-Admit

Specification Definition The intention of the responsible clinician, at the time of the patient’s separation

from hospital, to re-admit the patient within 28 days.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record



Reported when The Separation Date is reported. Otherwise, report spaces.


Select the first appropriate category:

0 Not applicable 1 Re-admission planned to this hospital within 28 days and booking

arranged 2 Re-admission planned to this hospital within 28 days but no booking

yet arranged 3 Re-admission planned to another acute hospital within 28 days and

booking arranged 4 Re-admission planned to another acute hospital within 28 days but no

booking yet arranged 9 No plan to re-admit within 28 days

Reporting guide For statistical separations, and for patients who have been transferred, died,

or left against medical advice, code 0 (zero) indicates not applicable.

For formal separations, this information should be recorded by the patient’s treating medical practitioner at the time of separation to indicate whether or not there is an intention on the part of the medical practitioner that the patient would be admitted within 28 days either to this hospital or to another acute hospital.

Intention to re-admit may be for treatment of a condition related to the one for which the patient was originally hospitalised or for another reason.

0 Not applicable

Includes: • Patient statistically separated (Separation Mode S). • Died in hospital (Separation Mode D). • Patient who left hospital at own risk against medical advice (Separation

Mode Z). • Patient transferred directly to another acute hospital, extended care,


rehabilitation or geriatric centre (Separation Mode T), even though arrangements may have been made to re-admit the patient back to this hospital.

Excludes: • Patients who go to an aged care residential facility. • Patients separated to a Transition Care bed based program

1, 2, 3 and 4 Re-admission planned Includes: • Patient whose re-admission is planned to this or another acute hospital

within 28 days with or without a booking. • Antenatal patient whose dates or medical condition indicate the birth could

be within 28 days. Excludes:

Separation Modes S, D, Z or T (use code 0 Not applicable).

9 No plan to re-admit within 28 days

Includes:

• Patient whose only plan is for an appointment for a non-admitted (outpatient) occasion of service.

• Patient whose medical practitioner has no plan to re-admit but expects the patient, of the patient’s own accord, may re-present at this or another hospital within 28 days because of debility, habit or a chronic condition.

Excludes:

• Antenatal patient whose dates or medical condition indicate the birth could be within 28 days (classify to appropriate re-admission planned code).

• Separation Modes S, D, Z or T (use code 0 Not applicable).

Edits 191 Invalid Intention to Readmit 192 Invalid Comb Int. Readmit/Sep Mode 193 Not Separated – Intent Readmit

Related items

Section 3: Separation Mode. Section 4: Business Rules (tabular) Intention to Readmit and Separation Mode


• Calculate rate of unplanned readmissions. • Provide clinical indicator data.



Collection start

1996-97


DH


Interpreter Required

Specification Definition The patient’s need for an interpreter, as perceived by the patient or person

consenting for the patient.

Data type

Numeric Form Code

Field size

1 Layout N or space

Location

Episode Record

Reported by Public hospitals (voluntary for private hospitals).




1 Yes 2 No 9 Not Stated/Inadequately Described

Reporting guide Preferred Language to be asked before Interpreter Required.

If the Preferred language is English, Interpreter Required can be assumed to be 2 No.

This data item must:

• Be checked for every admitted patient episode. • Not be set up to input a default code on computer systems. • Be collected on, or as soon as possible after, admission.

The standard question is:

[Do you] [Does the person] [Does (name)] require an interpreter?

The provision of the question ‘Do you require an interpreter?’ is asked to determine patient need for an interpreter, not the capacity of the hospital to provide an interpreter.

1 Yes

Use code 1 if the patient indicates they need an interpreter.

2 No

Use code 2 if the patient indicates they do not need an interpreter.

Includes: Where the Preferred Language is English.


9 Not Stated / Inadequately Described

Use code 9 if neither Yes nor No can be accurately ascertained.

Includes:

• Where the Preferred Language is 0002 Not Stated. • Some instances where the Preferred Language is 9000 Other Languages,

nfd or 0000 Inadequately described.

Patient is unable to consent (eg baby, child or elderly):

Where a person is not able to consent for themselves (eg baby, child or elderly) then the need for an interpreter is recorded for the person who is consenting. For example a guardian or someone with enduring power of attorney.

Edits 517 Invalid Interpreter Required

592 Invalid Comb Int Req/Pref Lang

Related items

Section 3: Country of Birth, Indigenous Status, and Preferred Language

Administration Purpose For planning and to form the basis for future funding allocation for Culturally and

Linguistically Diverse (CALD) hospital service provision.



Collection start

2003-04


CCDS


Leave with Permission Days Financial Year-to-Date


hospital ‘on leave with permission’ in the financial year being reported (includes the month being reported).

Data type


Field size

3 Layout NNN or spaces.

Right justified, zero filled.

Location

Episode Record


Reported for Episodes where there was a period of leave with permission for the financial

year-to-date.


Code set A valid number complying with the business rules.

Reporting guide Leave With Permission Days Financial Year-to-Date must be equal to or greater

than Leave With Permission Days Month-to-Date and equal to or less than Leave With Permission Days Total.

Edits 047 Leave W Perm Days YTD Not Numeric or Blank

053 Leave W Perm YTD< MTD 055 Leave W Perm Tot<YTD 224 Newborn With Leave

Related items

Section 2: Leave With Permission and Leave Without Permission.

Section 3: Leave with Permission Days Month-to-Date, and Leave with Permission Days Total.

Section 4: Business Rules (non-tabular) Leave.

Administration Purpose To balance (for validation purposes) ‘patient days’ (patient’s length of stay) (by

the addition of leave days) against the difference between Admission Date and Separation Date.


Automated PRS/2 processes.

Collection start

1990-91



Leave with Permission Days Month-to-Date


hospital ‘on leave with permission’ in the month being reported (month-to-date).

Data type


Field size

2 Layout NN or spaces.


Location

Episode Record


Reported for Episodes where there was a period of leave with permission for the month.



Reporting guide Leave With Permission Days Month-to-Date must be equal to or less than Leave

With Permission Days Financial Year-to-Date and Leave With Permission Days Total.

Edits 046 Leave W Perm Days MTD Not Numeric or Blank

053 Leave W Perm YTD< MTD 055 Leave W Perm Tot<YTD 224 Newborn With Leave

Related items


Section 3:

Leave with Permission Days Financial Year-to-Date, and Leave with Permission Days Total.






Collection start

1990-91



Leave with Permission Days Total


hospital ‘on leave with permission’, including days from the previous financial year/s.

Data type


Field size



Location

Episode Record


Reported for Episodes where there was a period of leave with permission.



Reporting guide Leave With Permission Days Total must be equal to or greater than Leave With

Permission Days Month-to-Date and Leave With Permission Days Financial Year-to-Date.

Edits 049 Leave W Perm Days Tot Not Numeric or Blank

054 Leave W Perm Tot<MTD 055 Leave W Perm Tot< YTD 112 Calc Los + Leave Not = Adm/Sep 224 Newborn With Leave

Related items


Section 3:

Leave with Permission Days Financial Year-to-Date, and Leave with Permission Days Month-to-Date.



the addition of normal leave days) against the difference between Admission Date and Separation Date.



Collection start

1990-91



Leave without Permission Days Financial Year-to-Date


hospital ‘on leave without permission’ in the financial year being reported (includes the month being reported).

Data type


Field size



Location

Episode Record


Reported for Episodes where there was a period of leave without permission for the financial

year-to-date.



Reporting guide Leave Without Permission Days Financial Year-to-Date must be equal to or

greater than Leave Without Permission Days Month-to-Date and equal to or less than Leave Without Permission Days Total.

Edits 224 Newborn With Leave

566 Leave W/O Perm Days YTD Not Numeric or Blank 568 Leave W/O Perm YTD< MTD 570 Leave W/O Perm Tot<YTD

Related items


Section 3: Leave Without Permission Days Month-to-Date and Leave Without Permission Days Total.







Collection start

2004-05


Leave without Permission Days Month-to-Date


hospital ‘on leave without permission’ in the month being reported (month-to-date).

Data type


Field size

2 Layout NN or spaces.


Location

Episode Record


Reported for Episodes where there was a period of leave without permission for the month.



Reporting guide Leave Without Permission Days Month-to-Date must be equal to or less than

Leave Without Permission Days Financial Year-to-Date and Leave Without Permission Days Total.

Edits 224 Newborn With Leave

565 Leave W/O Perm Days MTD Not Numeric or Blank 568 Leave W/O Perm YTD< MTD 569 Leave W/O Perm Tot < MTD

Related items


Section 3: Leave Without Permission Days Financial Year-to-Date page 3-121, and Leave Without Permission Days Total page 3-123.







Collection start

2004-05


Leave without Permission Days Total


hospital ‘on leave without permission’, including days from the previous financial year/s.

Data type


Field size



Location

Episode Record


Reported for Episodes where there was a period of leave without permission.



Reporting guide Leave Without Permission Days Total must be equal to or greater than Leave

Without Permission Days Month-to-Date and Leave Without Permission Days Financial Year-to-Date.

Edits 112 Calc Los + Leave Not = Adm/Sep

224 Newborn With Leave 567 Leave W/O Perm Days Tot Not Numeric or Blank 569 Leave W/O Perm Tot<MTD 570 Leave W/O Perm Tot< YTD

Related items


Section 3: Leave Without Permission Days Financial Year-to-Date and Leave Without Permission Days Month-to-Date.




Principal data users Automated PRS/2 processes.


Collection start

2004-05


Locality

Specification Definition Geographic location (suburb/town/locality for Australian residents, country for

overseas residents) of usual residence of the person (not postal address).

Data type


Field size

22 Layout AAAAAAAAAAAAAAAAAAAAAA Left justified.

Location

Episode Record




Code set Refer to the Postcode/Locality reference file available from:


Reporting guide Australia Post web-site listing of postcodes and localities is available from: www.auspost.com.au

The DH file excludes non-residential postcodes listed in the Australia Post file. Common variations of locality spellings, as used in Melway references and the Australian Bureau of Statistics National Locality Index (Cat. No. 1252), are included in the DH file.

Locality must be blank if the Postcode is 1000 or 9988. Where the Postcode is 8888 (overseas), report the country the patient lives in, in Locality. The four digit country code must be one that corresponds with a code listed against 8888 (overseas) in the Postcode/Locality reference file.

Edits 058 Invalid Postcode/Locality

571 Acct Recip, Pcode Oseas, Locality Not RHCA 574 Postcode Overseas, Locality RHCA, Acct Not RHCA

Related items

Section 3: Postcode.

Section 4: Business Rules (tabular) Locality/Postcode.

Administration Purpose To enable calculation (with Postcode field) of the patient’s appropriate Statistical

Local Area (SLA) which enables:



http://www.auspost.com.au/

• Analysis of service utilisation and need for services. • Identification of patients living outside Victoria for purposes of cross-border

funding. • Identification of patients living outside Australia for the Reciprocal Health

Care Agreement (RHCA).


Multiple internal and external users.



source ABS National Locality Index (Cat. No. 1252)(DH modified)


Marital Status

Specification Definition Current marital status of the person.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record





1 Never married 2 Widowed 3 Divorced 4 Separated 5 Married 6 De facto 9 Not stated / inadequately described

Reporting guide Report the current marital status of the person.

Edits 034 Invalid Marital Status

061 Married - Age Not Within Range

Related items

-

Administration Purpose To facilitate social and epidemiological studies.


Multiple internal and external users.

Collection start

1979-80


CCDS


Medicare Number

Specification Definition Personal identifier allocated by Medicare Australia to eligible persons under the

Medicare scheme.

Data type

Numeric Form Code

Field size

11 Layout NNNNNNNNNNN or spaces (all zeros are invalid).

Location

Episode Record


Reported for Public hospitals: All patients except in the circumstances covered under

Medicare Suffix.

Private hospitals: All contracted patients and for all other patients, where possible. The exceptions are covered under Medicare Suffix.


Code set The patient’s Medicare number and code, issued by Medicare Australia.

Reporting guide Valid:

• First character can only be a: 2, 3, 4, 5, or 6 • Numeric or all blanks • Check digit (ninth character) is the remainder of the following equation: [(1st

digit * 1) + (2nd digit * 3) + (3rd digit * 7) + (4th digit * 9) +(5th digit * 1) + (6th digit * 3) + (7th digit * 7) + (8th digit * 9)] / 10

Invalid:

• Special characters (for example, $, #) • Alphabetic characters • Zero-filled (if the Medicare number is not available or not applicable, the

Medicare number must be left blank)


The Medicare number is printed in the centre on the Medicare card.

The Medicare code is also called the ‘eleventh character’ of the number.

It is the number printed to the left of the name of the patient.

Neonates For neonates who have not yet been added to the family Medicare card, and therefore have no Medicare code, there are two reporting options: • Mother's/family's Medicare number in the first ten characters and a zero (0)

as the eleventh character • Mother's/family's Medicare number in the first ten characters and the

mother's code as the eleventh character.

Edits 030 Invalid Medicare number 518 Medicare Code = 0, Age > 6 Months 519 Medicare Code = 0, Age > 12 Months

Related items

Section 2: Asylum Seeker, and Medicare Eligibility Status – Eligible Person, and Medicare Eligibility Status – Ineligible Person.

Section 3: Medicare Suffix.


• Assist in monitoring continuity of care across hospitals. • Ensure eligibility for publicly funded health care.



Collection start

1979-80


Medicare Australia


Medicare Suffix

Specification Definition First three characters of patient’s first given name (as it appears on the persons

Medicare card).

Data type

Alphanumeric Form Abbreviation/Code

Field size

3 Layout XXX or A-A

Location

Episode Record




Code set The first 3 characters of the patient’s first given name.

Characters permitted:

• Upper case alphas • Space as second and third characters • Space as third character • Hyphen or apostrophe as second character or hyphen or apostrophe as third

character.

If Medicare number is unavailable or the patient is not eligible for a Medicare number, leave the Medicare number blank (not zero-filled) and enter the appropriate suffix:

Code Descriptor

C-U Card unavailable/Not applicable

N-E Not eligible for Medicare

P-N Prisoner

Reporting guide RCHA

For patients with Account Class MA Reciprocal Health Care Agreement, report C-U

Unnamed neonate

For unnamed neonates where the family has a Medicare number, report a Medicare suffix of 'BAB'. The Medicare number issued to the mother/family must also be reported with • A Medicare code ('eleventh character') of zero (0), OR • The Medicare code of the mother.


Edits 031 Blank Medicare Suffix 032 Invalid Medicare Suffix 094 Comb A/C Accom Care Med Suff 329 Geri Respite – Invalid Comb 454 Incompat Fields for Interim Care

Related items

Section 2: Asylum Seeker, and Medicare Eligibility Status – Eligible Person, and Medicare Eligibility Status – Ineligible Person.

Section 3: Medicare number.

Section 4:

Business Rules (tabular) Account Class, Acc Type, Care Type and Medicare Suffix and Account Class: Geriatric Respite.


• Assist in monitoring continuity of care across hospitals. • Ensure eligibility for publicly funded health care.



Collection start

1979-80


-


Mental Health Legal Status

Specification Definition Whether a person is treated on an involuntary basis under the relevant State

mental health legislation, at any time during an admitted episode of care.

Involuntary patients are persons who are detained in hospital under mental health legislation for the purpose of assessment or provision of appropriate treatment or care.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record





1 Involuntary for all or part of this episode 2 Not involuntary at any time during this episode 9 Not applicable

Reporting guide Private hospitals

Report code 9 Not applicable for all patients as private hospitals are not proclaimed to provide services for involuntary patients.

Public hospitals

Patients in Care Type 5x Approved Mental Health Service or Psychogeriatric Program in public hospitals whose care is funded by Mental Health Services:

• Report either code 1 Involuntary or code 2 Not involuntary. • Only hospitals with Approved Mental Health Services can report codes 1 or 2.

Where a patient is treated under contract at such an Approved Mental Health Service (as Hospital B in a contracted service arrangement), only the contract service provider (Hospital B) should report codes 1 or 2; the contracting hospital (Hospital A) should report code 9 Not applicable for the contracted component of that episode.

Patients in Care Type 1 NHT/Non-Acute in public hospitals whose care is funded by Mental Health Services: • Report code 9 Not applicable. Patients in all Care Types, other than Care Type 5x Approved Mental Health Service or Psychogeriatric Program, in public hospitals: • Report code 9 Not applicable.


Edits 108 Field(s) are Missing From Sep 265 Mental Health Status - Not Separated 266 Invalid Legal Status 268 Inv Comb Legal, Status, Care & PFS 329 Geri Respite – Invalid Comb 334 Hospital Generated DRG Not = PRS/2 DRG 454 Incompat Fields for Interim Care 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 626 Invalid Combination for Funding Arrangement PHESI

Related items

Section 4:

Business Rules (tabular) Account Class: Geriatric Respite, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission: Secondary Family Member, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative, and Funding Arrangement: Private Hospitals Elective Surgery Initiative.

Administration Purpose To enable grouping into AR-DRGs.




source DH


Mental Health State Wide Patient Identifier

Specification Definition The client identifier, unique to the client for approved Mental Health Service and

Psychogeriatric Programs.

Data type

Alphanumeric

Form Code

Field size

10 Layout NNNNNNNNNN or spaces


Location

Episode Record

Reported by All Victorian public hospitals with an approved Mental Health Service.

Private hospitals: Report spaces in this field.

Reported for All mental health admitted episodes of care (Care Type 5x) and Care Type 4

episodes in which an ECT has been performed.

Reported when The episode record is reported.

Code set

ODS generated.

Reporting guide Report the primary Mental Health State-wide Patient Identifier for all mental health episodes of care (Care Types 5x) and episodes reported in which an ECT has been performed, and with an ACHI code in the range 93341-00 to 93341-99.

Edits 575 Care Type 5x, MHSWPI Blank

576 Invalid MHSWPI

577 MHSWPI not on ODS 578 MHSWPI Present, not Care Type 5x 579 MHSWPI Valid, no Matching DOB 580 MHSWPI Valid, no Matching Sex 581 MHSWPI Valid, Secondary on ODS 660 Care Type ≠ 5x, LOS Same Day, Procedure Code 93341-xx, MHSWPI mismatch 661 Care Type ≠ 5x, Procedure Code 93341-xx, LOS ≠ Same Day MHSWPI mismatch


Related items

Section 9: Supplementary Code Lists:

Care Type

Care Type 5A: Mental Health Service and Psychogeriatric Program – Acute, Adult Mental Health Service, and Care Type 5E: Mental Health Service and Psychogeriatric Program – Mental Health Secure Extended Care Unit (SECU), and Care Type 5G: Mental Health Service and Psychogeriatric Program – Acute, Aged Persons Mental Health Service (APMH), and Care Type 5K: Mental Health Service and Psychogeriatric Program – Child and Adolescent Mental Health Service (CAMHS), and Care Type 5S: Mental Health Service and Psychogeriatric Program – Acute, Specialist Mental Health Service, and Care Type 5T: Mental Health Service and Psychogeriatric Program – Mental Health Nursing Home Type.

Administration Purpose To enable management of clients and their associated data.

Principal data users Mental Health, Drugs & Regions, DH



source ODS generated


Mother’s UR

Specification Definition The UR Number (Patient Identifier) of the mother of the baby.

Data type


Field size

10 Layout XXXXXXXXXX or spaces


Location

Episode Record

Reported by Victorian hospitals (public and private).

Reported for Public Hospitals: Newborn episodes where both mother and baby are admitted.

Private hospitals: Newborn episodes where both mother and baby are admitted and the newborn episode is reported.


Code set Valid Patient Identifier.

Reporting guide When the baby is born in hospital during this episode of care, report the Patient

Identifier of the mother’s episode of care.

If the baby was not born during this episode of care, but both mother and baby are admitted to the hospital, report the Patient Identifier of the mother’s episode of care.

Edits 652 Invalid format Mother’s UR

653 Mother’s UR and Admission Source mismatch

654 Mother’s UR does not exist

Related items

Section 3: Patient Identifier

Administration Purpose To enable analysis of the factors affecting the care of both the mother and baby.


Internal and External data users.

Collection start

2009-10


Hospitals


Onset Date

Specification Definition Date of admission for the acute episode for care, relating to an injury or disease

condition, for which the person has now been admitted for a subsequent rehabilitation episode of care.

Data type

Numeric Form Date

Field size 8 Layout DDMMYYYY or spaces.



Reported for Episodes with Care Type P, 2, 6, 7 or K. For Care Types 8, 9, F and E, report

spaces in this field.


Code set Valid date

Reporting guide Onset Date must be equal to or earlier than the Admission Date, and after the Date of Birth.

The Admission Date of the acute episode should be obtained from the acute hospital where the acute episode occurred.

If the patient is admitted to rehabilitation directly from the community, this field should match the date of admission in the Episode Record.

Edits 255 Rehab: Invalid Onset Date 258 Sub-Acute: No Sub-Acute Record 289 Adm Sc is T’fer & Onset = Adm Date 290 Stat Adm Sc & Onset = Adm Date 294 Onset Date Present 454 Incompat Fields for Interim Care

Related items

Section 2: Rehabilitation Care. Section 4: Business Rules (tabular) Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).

Administration Purpose To enable measurement of the time elapsed since the initial acute episode, to

support and further develop casemix classifications for sub-acute episodes.


Continuing Care and Clinical Service Development (Hospital & Health Service Performance, DH).

Collection start

1995-96



Patient Days Financial Year-to-Date

Specification Definition The number of patient days the person has accrued during the current financial

year-to-date excluding leave with and without permission days (includes the month being reported). (Total of patient days recorded in each of the status segments.)

Data type


Field size

3 Layout NNN


Location

Status Segments of the Episode Record.





Reporting guide Patient Days includes Contacted Leave Days.

Patient Days Financial Year-to-Date must be equal to or greater than Patient Days Month-to-Date and equal to or less than Patient Days Total.

Edits 076 Not Sufficient Fields First Status

077 Not Sufficient Fields Other Status 087 Pt Days YTD Not Numeric Or Blank 091 Pt Days YTD <MTD 093 Pt Days Total< YTD

Related items

Section 2: Contracted Care and Patient Day. Section 3: Contract Leave Days Financial Year-to-Date, Contract Leave Days Month-to-Date, Contract Leave Days Total, Patient Days Month-to-Date , and Patient Days Total. Section 4: Business Rules (non-tabular) Length of Stay. Section 5: Status Segments.

Administration Purpose To enable hospitals to reconcile YTD days reported each month.





Patient Days Month-to-Date

Specification Definition The number of patient days the person has accrued during the current month

excluding leave with and without permission days, where current month refers to the month nominated by the Header start and end dates. (Total of patient days recorded in each of the status segments.)

Data type


Field size

2 Layout NN


Location Status Segments of the Episode Record.






Patient Days Month-to-Date must be equal to or less than Patient Days Financial Year-to-Date and Patient Days total.

Edits 076 Not Sufficient Fields First Status 077 Not Sufficient Fields Other Status 086 Pt Days MTD Not Numeric Or Blank 091 Pt Days YTD<MTD 092 Pt Days Total<MTD

Related items

Section2: Contract Care and Patient Day. Section 3: Contract Leave Days Financial Year-to-Date, Contract Leave Days Month-to-Date, Contract Leave Days Total, Patient Days Financial Year-to-Date, and Patient Days Total. Section 4:

Business Rules (non-tabular) Length of Stay. Section 5: Status Segments.

Administration Purpose To enable hospitals to reconcile MTD days reported each month.


Collection start

1983-84



Patient Days Total

Specification Definition The total number of patient days the person has accrued during the whole

episode of care to date excluding leave with and without permission days (includes the month being reported). (Total of patient days recorded in each of the status segments.)

Data type


Field size

4 Layout NNNN


Location







Patient Days Total must be equal to or greater than Patient Days Month-to-Date and Patient Days Financial Year-to- Date.

Edits 076 Not Sufficient Fields First Status

077 Not Sufficient Fields Other Status 089 Pt Days Tot < Not Numeric Or Blank 092 Pt Days Total < MTD 093 Pt Days Total <YTD 096 Total Days Can’t Be Zero 112 Calc LOS + Leave Not = Adm /Sep 113 Same Day Status: Total Pt Days Not 1 243 Unqual Newborn But Total Days > 9 432 MAPU or SOU > 48 Hours 607 Care Type Pall Care: Pall Care Pt Days not = Pt Days Total


Related items

Section 2: Contracted Care and Patient Day.

Section 3: Contract Leave Days Financial Year-to-Date, Contract Leave Days Month-to-Date, Contract Leave Days Total, Patient Days Financial Year-to-Date, and Patient Days Month-to-Date.

Section 4: Business Rules (non-tabular) Length of Stay.


Administration Purpose Major measure of resource use. Also identifies whether episode is:

• An inlier or outlier for the appropriate DRG. • Same day or one day or multi day.

Principal data users Multiple internal and external users.


Definition source

DH


Patient Identifier

Specification Definition An identifier, unique to a patient within this hospital or campus (patient’s record

number/unit record number).

Data type


Field size

10 Layout XXXXXXXXXX


Location

Episode Record Sub-Acute Record DVA and TAC Record

Reported by Victorian hospitals (public and private).


Reported when The Episode Record, Sub-Acute Record or DVA and TAC Record are reported.

Code set Hospital-generated. Individual sites may use their own alphabetic, numeric or alphanumeric coding system.

Reporting guide If multiple campuses transmit to PRS/2 in a single file, the Patient Identifier must be unique to the service. If the campuses transmit data separately to PRS/2, the Patient Identifier must be unique to each campus.

All newborns must have their own Patient Identifier. This cannot be the newborn’s mother’s Patient Identifier but could be the mother’s Patient Identifier with a prefix or suffix.

Edits 026 Zero Sep; Existing Not Discharged 027 Adm Record; Overlaps Existing 028 Prior Adm; No Sep Date 029 Invalid Pt ID 062 Duplicate Pt ID, Adm Date Time, Diff Unique 063 Prior Not Discharged 064 Duplicate Pt ID, Date Time 248 Tran Pt ID Not Same As Episode Or Sub Ac 499 Stat Admission: No Prev Episode 510 Stat Sep Mode: No Subsequent Episode 531 Same UK, diff Pt ID

Related items -

Administration Purpose To enable relevant episodes to be updated and provide the potential for

episodes to be linked across patient settings.




Hospitals


Postcode

Specification Definition Postcode or locality in which the person usually resides (not postal address).

Data type

Numeric Form Code

Field size

4 Layout NNNN

Location

Episode Record




Code set Refer to the Postcode/Locality reference file available from:


Other codes for use in this field:

Code Descriptor

1000 No fixed abode 8888 Overseas (Report the four digit country code in the Locality field.) 9988 Unknown

Reporting guide The Australia Post listing of postcodes and localities is available from:

www.auspost.com.au From the Australia Post list, non-residential postcodes are excluded and common variations of locality spellings, as used in Melway references and the Australian Bureau of Statistics National Locality Index (Cat. No. 1252), are included.

The hospital may collect the patient’s postal address for its own purposes. However, for transmission to PRS/2, the Postcode must represent the patient’s residential address. PRS/2 will reject non-residential Postcodes (such as mail delivery centres).

For newborns, use the postcode of mother’s residential address.

Locality must be blank if the Postcode is 1000 or 9988. Where the Postcode is 8888 (overseas), report the country the patient lives in, in Locality. The four digit country code must be one that corresponds with a code listed against 8888 (overseas) in the Postcode/Locality reference file.

Edits 058 Invalid Postcode/Locality

391 Recip HCA Account, Not O/Seas P/Code 571 Acct Recip, Pcode Oseas, Locality Not RHCA 572 Postcode Overseas, Account Not Recip, or Inelig



573 Postcode Overseas, Account Public 574 Postcode Overseas, Locality RHCA, Acct Not RHCA

Related items

Section 3: Locality. Section 4: Business Rules (tabular) Locality/Postcode.

Administration Purpose Used for calculation (with Locality field) of the patient’s appropriate Statistical

Local Area (SLA) to:

• Analyse service utilisation and need for services. • Identify patients living outside Victoria for purposes of cross-border

funding. • Identify patients living outside Australia for the Reciprocal Health Care

Agreement (RHCA).

Principal data users Multiple internal and external users.



source Australia Post (DH modified)


Preferred Language

Specification Definition The language (including sign language) most preferred by the patient for

communication. This may be a language other than English even where the person can speak fluent English.

Data type

Numeric Data type

Code

Field size

4 Layout

NNNN or spaces

Location

Episode Record

Reported by Public hospitals (voluntary for private hospitals).



Code set See Section 9: Codes Lists: Preferred Language.

Reporting guide This information must:

• Be checked for every admitted patient episode. • Not be set up to a default code on computer systems. • Be collected on, or as soon as possible after, admission.

The standard question is: What is [your] [the person’s] preferred language?

Patient is unable to consent (for example baby, child or elderly): Where a person is not able to consent for themselves (for example baby, child or elderly) then the language of the person who is consenting will be recorded. For example a guardian or someone with enduring power of attorney.

8000 Australian Indigenous languages, NEC

Includes: All Australian Indigenous languages not shown separately on the code list.

0002 Not Stated Includes: • Patients who are not able to respond to this question at any time during their

hospital stay. • Child unaccompanied by an adult, who is too young to identify preferred

language in relation to the ability to consent. • This question on the form was not filled in, or filled in correctly and cannot be

verified throughout the admission.


Edits 511 Invalid Preferred Language 513 Indigenous Status/Preferred Language Mismatch 514 Language is Unspecified 592 Invalid Comb Int Req/Pref Lang

Related items

Section 3: Country of Birth, Indigenous Status, and Interpreter Required. Section 9:

Codes Lists Preferred Language.

Administration Purpose For planning and to form the basis for future funding allocation for Culturally And

Linguistically Diverse (CALD) hospital service provision.


Clinical Governance Unit, DH

Collection start

2003-04


NHDD; ABS mod Aust. Stand. Classification 2nd Edition (2005)


Procedure Start Date Time

Specification Definition Date and Time at which a procedure commenced for an admitted patient.

Data type

Numeric Form Datetime

Field size

12 Layout DDMMYYYYHHMM or spaces

Location

Diagnosis Record


Reported for All admitted episodes of care where a procedure occurring in an operating room or a cardiac catheter laboratory or involving a scope is recorded as the first coded procedure.

(Note: Time of procedure is optional and may be reported as spaces, e.g. ‘01052009 ‘).

Reported when The Diagnosis Record is reported.

Code set Valid datetime.

Reporting guide Procedure Start Datetime should be reported for an episode where the first coded procedure is one identified in the ICD-10-AM/ACHI Library file for the current year as requiring the procedure start date time:

[On Library file: column K, Coding practices, code 4]

The Library file is available from: http://www.health.vic.gov.au/hdss/icdcoding/libfilesindex.htm

The procedure is deemed to have commenced when:

• The first incision is made for a surgical procedure. • The instrument is inserted for procedures in a cardiac catheter laboratory or

those involving the use of a scope. If the time of commencement is not available report DDMMYYYY and four spaces. If this data element is inapplicable to the episode, report all spaces in this field.

Edits 655 Invalid Procedure Start DateTime

656 Proc Start DateTime < Adm Date or > Sep Date 657 Proc Start DateTime and Valid Proc Mismatch

Related items Section 3 Procedure codes

Administration Purpose To enable analysis of wait times for surgical and significant procedures.


http://www.health.vic.gov.au/hdss/icdcoding/libfilesindex.htm


Access & Metropolitan Performance, DH

Collection start

2009-10



Procedure Codes

Specification Definition Up to 40 ACHI Seventh Edition codes reflecting the interventions used for the

diagnosis and/or treatment of ill health during this episode of care.

Data type


Field size

8 (x 40) Layout NNNNNNN 8th character - A or space.

Left justified, trailing spaces.

Location

Diagnosis Record (12)

Extra Diagnosis Record (28)




Code set DH ICD-10-AM/ACHI/ACS Library File 2011-12, available at:

http://www. health.vic.gov.au/hdss/reffiles/vaed/libfil10.htm Where no procedures were performed, report spaces.

Reporting guide Character 1-7 must contain a numeric code of seven characters.

Character 8 must be F, N or space.

Report procedures undertaken during this episode of care in accordance with the Australian Coding Standards Seventh Edition and the Victorian Additions to Australian Coding Standards. The Victorian Additions to Australian Coding Standards are available at: http://www.health.vic.gov.au/hdss/icdcoding/index.htm Omit punctuation as shown in ACHI books (no dash in codes); for example, ACHI procedure code 40903-00 Neuro-endoscopy must be entered 4090300. Do not transmit Block numbers.


http://www.health.vic.gov.au/hdss/icdcoding/index.htm

Procedures performed under contract at another agency Procedures performed at another hospital under contract to this hospital are recorded by both hospitals (where the episode is admitted by both hospitals), but flagged in the contracting hospital only, by use of a flag in the eighth character allocated for each procedure code. • ‘F’ indicating the procedure was performed at another hospital on an admitted

basis. • ‘N’ indicating the procedure was performed at another hospital on a

non-admitted basis.

Edits 127 Nil Value DRG 160 AR-DRG Grouper GST Code>Zero 195 Blank X4 197 Embedded Blank Diag Oper 320 MV Duration But No Procedure Code 334 Hosp Generated DRG Not = PRS/2 DRG 351 Illegal Code Format 352 Code Not found On Code File 353 Code & Age Incompatible 354 Code & Sex Incompatible 358 Area Code Restraint 408 Contract Role ‘A’ W/Out Proc Flag 409 Proc Flag W/out Contract Role ’A’ 428 X4 Upd not Accompanied by Y4 Upd 450 Code Incompatible W Female Sex 451 Code Incompat W Male Sex 596 Same Day ECT: Not in Care Type 4 600 Invalid Code 641 MV Hours with Incorrect Procedure Code 644 NIV Hours with Incorrect Procedure Code

Related items

Section 2: Contracted Care, DRG Classification and Procedure. Section 3: Hospital Generated DRG. Section 4: Business Rules (non-tabular) Contracted Care.

Administration Purpose To facilitate:

• Epidemiological studies and other research. • Grouping for casemix purposes.




source ACHI Seventh Edition


Program Identifier

Specification Definition Identifies the specified program, if any, which applies to this episode of care.

Data type


Field size

2 Layout NN or space

Location

Episode Record

Reported by Public and Private Hospitals.

Reported for Episodes for patients admitted under a specified DH program.

Otherwise, report a space in this field.

Reported when An Episode Record is transmitted.


02 23 Hour Surgery Unit 03 Restorative Care 04 GEM Level 1 05 Home Birthing Program Reporting guide Report the corresponding code for the program when advised to do so by the

Department of Health’ unit responsible for administration of the program, or by AEED.

02 23 Hour Surgery Unit

Patient identified as a 23 Hour Surgery Unit patient. Use code 02 only.

03 Restorative Care

Patient identified as a Restorative Care patient as approved by DH. Use code 03 only with Care Type K.

04 GEM Level 1

Patient identified as a GEM Level 1 patient as approved by DH. Use code 04 only with Care Type 9

05 Home Birthing Program

Patient identified as a Home Birthing Program patient as approved by DH. Use code 05 only.


Edits 648 Invalid Program Identifier 649 Program Identifier Mismatch 650 Program Identifier 03, not approved for Restorative Care 651 Program Identifier 04, not approved for GEM Level 1

Related items

Administration

Purpose To:

• Identify whether a specified program applies to this episode. • Facilitate health services planning and monitoring.






Qualification Status

Specification Definition Qualification status indicates whether each patient day within a newborn

episode of care is either qualified or unqualified.

Data type

Alpha Form Code

Field size

1 Layout A

Location






N Qualified newborn

U Unqualified newborn X Not applicable

Reporting guide Status Segments are used to record changes between Qualified and

Unqualified status for newborns and the duration of these periods (Patient Days).

The patient’s Qualification Status ‘as of midnight’ should be reported to VAED. If the Qualification Status changes more than once during the day, report the last Qualification Status before midnight.

For all other admitted patients, a single Qualification Status code (X) is recorded; indicating newborn qualification status is not relevant to this patient.

N Qualified newborn

A newborn who, for the patient days being recorded in this Status Segment, meets at least one of the following criteria to be a ‘Qualified Newborn’. • Admitted to facilities approved by the Commonwealth Minister for the

provision of special care in designated neonatal intensive care units (NICUs) and designated special care nurseries (SCNs), or

• Is the second or subsequent live born of a multiple birth, or • Remains in hospital after their mother is separated from hospital, or • Is admitted to hospital without their mother. U Unqualified newborn

A newborn who, for the patient days being recorded in this Status Segment, does not meet any of the qualifications to be a ‘Qualified Newborn’.

X Not applicable

An admitted patient other than a newborn.


Edits 076 Not Sufficient Fields First Status 077 Not Sufficient Other Status 098 Invalid Qual Type 224 Newborn With Leave 241 Illegal Qual Stat Combination N &Y 242 Illegal Qual Stat Combination U &X 243 Unqual Newborn But Total Days > 9 260 Invalid Care For Qual 329 Geri Respite – Invalid Comb 403 Qual Newborn W/Out Justificat 434 NICU/SCN Accom But Unqual Newborn 454 Incompat Fields for Interim Care 466 Adm Type L & Newborn Qual Status 483 Incompat Adm Source/Qual Stat 485 Incompat Adm Type/Qual Stat 487 Incompat Age/Qual Stat 490 Incompat Crit For Adm/Qual Stat 491 Incompat Fields for ESAS 492 Incompat Fields for RPI 626 Invalid Combination for Funding Arrangement PHESI 642 Unqualified Newborn but Separation Mode D

Related items

Section 2: Acute Care, Criterion for Admission, Episode of Admitted Patient Care, Newborn, Qualification (Newborn) and Sub-Acute Care.

Section 3: Care Type.

Section 4:

Business Rules (non-tabular) Episode of Care and Newborn Reporting.

Business Rules (tabular) Account Class: Geriatric Respite, and Admission Source and Qualification Status, and Admission Type and Qualification Status, and Age and Qualification Status, and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E), and Criterion for Admission and Newborn Qualification Status (1st Status Segment), and Criterion for Admission and Qualification Status, and Funding Arrangement: Elective Surgery Access Service, and Funding Arrangement: Rural Patients Initiative, and Funding Arrangement: Private Hospitals Elective Surgery Initiative, and Newborns: Criteria for Admission, Qualification Status, Care Type.


Administration Purpose To enable removal of unqualified newborn days, and episodes where the

newborn is unqualified for the entire length of stay, to satisfy reporting requirements under the AHCA.

Principal data users Australian Institute of Health & Welfare.



DH


RUG ADL on Admission (a)

RUG ADL on Separation (b)

Specification Definition RUG ADL (Resource Utilisation Group Activities of Daily Living):

(a) As assessed on admission. (b) As assessed on separation.

Data type

Numeric Form Score

Field size

2 Layout NN or spaces Right justify, leading zeros.

Location

Sub-Acute Record


Reported for Episodes with Care Type 8. For Care Types P, 2, 6, 7, K, 9, F and E, report spaces in this field.


Code set Cumulative Score, out of 18. On admission, a minimum score of 04 must be reported. Refer to the RUG ADL Score Table following.

Reporting guide Record what the person actually does, not what they are capable of doing; that is, record the lowest performance of the assessment period.

If the person dies in hospital, record a score of 00 for the Separation RUG ADL.

On the score sheet, do not leave any spaces blank. It is essential that each data collector knows what behaviours and/or tasks are contained within each item and have a ‘working knowledge’ of the scale.

RUG ADL Score

RUG Item Score

Definition

Bed Mobility

Ability to move in bed after the transfer into bed has been completed.

Independent supervision

1 Able to readjust position in bed, and perform own pressure area relief, through spontaneous movement around bed or with prompting from carer. No hands-on assistance required. May be independent with the use of a device.

Limited assistance 3 Able to readjust position in bed, and perform own pressure area relief, with the assistance of one person.

Other than two persons

4 Requires the use of a hoist or other assistive device to readjust position in bed and provide pressure relief. Still requires the assistance of one person for task.

Two or more persons physical assist

5 Requires 2 or more assistants to readjust position in bed, and perform pressure area relief.


RUG Item Score

Definition

Toileting Includes mobilising to the toilet, adjustment of clothing before and after toileting and maintaining perineal hygiene without the incidence of incontinence or soiling of clothes. If level of assistance differs between voiding and bowel movement, record the lower performance.

Independent/ supervision

1 Able to mobilise to toilet, adjusts clothing, cleans self, adjusts clothing, and has no incontinence or soiling of clothing. All tasks are performed independently or with prompting from carer. No hands-on assistance required. May be independent with the use of a device.

Limited assistance 3 Requires hands-on assistance of one person for one or more of the tasks. Other than two persons physical assist

4 Requires the use of a catheter/uridome/urinal and/or colostomy/bedpan/commode chair and/or insertion of enema/ suppository. Requires assistance of one person for management of the device.


5 Requires two or more assistants to perform any step of the task.

Transfer Includes the transfer in and out of bed, bed to chair, in and out of shower/tub. Record the lowest performance of the day/night.


1 Able to perform all transfers independently or with prompting of carer. No hands-on assistance required. May be independent with the use of a device.

Limited assistance 3 Requires hands-on assistance of one person to perform any transfer of the day/night.

Other than two persons physical assist

4 Requires use of a device for any of the transfers performed in the day/night. Requires only one person plus a device to perform the task.


5 Requires 2 or more assistants to perform any transfer of the day/night.

Eating Includes the tasks of cutting food, bringing food to mouth and chewing and swallowing food. Does not include preparation of the meal.


1 Able to cut, chew and swallow food, independently or with supervision, once meal has been presented in the customary fashion. No hands-on assistance required. If individual relies on parenteral or gastrostomy feeding that he/she administers him/herself then Score 1.

Limited assistance 2 Requires hands on assistance of one person to set up or assist in bringing food to the mouth and/or requires food to be modified (soft or staged diet).

Extensive assistance/ total dependence/ tube fed

3 Person needs to be fed meal by assistant, or the individual does not eat or drink full meals by mouth but relies on parenteral/ gastrostomy feeding and does not administer feeds by him/herself.

TOTAL (Score out of 18) Edits (a) 258 Sub-Acute: No Sub-Acute Record

303 Pal Care But Invalid Adm RUG ADL 305 Adm RUG ADL Present 454 Incompat Fields for Interim Care


(b) 258 Sub-Acute: No Sub-Acute Record 297 Sep RUG ADL & Sep Mode Incompatible 304 Pall Care But Invalid Sep RUG ADL 306 Sep RUG ADL Present 454 Incompat Fields for Interim Care

Related items

Section 2: Palliative Care. Section 4: Business Rules (tabular) Care Type: Designated and non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).

Administration Purpose To support and further develop casemix classifications for sub-acute episodes

of care.


Continuing Care and Clinical Service Development (Hospital & Health Service Performance, DH).

Collection start

1996-97


RUG ADL


Separation Date

Specification Definition Date on which an admitted patient completes an episode of care.

Data type

Numeric Form Date

Field size

8 Layout DDMMYYYY

Location

Episode Record DVA and TAC Record



Reported when The episode of care is completed.

Code set A valid date.

Reporting guide The Separation Date must be on or after the Admission Date.

If no other separation details are submitted (patient not yet separated), zero-filled Separation Date is accepted.

The Separation Date may relate to a formal or statistical separation.

Statistical Separations

Statistical Separation must have a Separation Date equalling the next episode’s Admission Date. Statistical separations and admissions cannot occur over midnight.

Edits 026 Zero Sep; Existing not Discharged

027 Adm Record; Overlaps Existing 028 Prior Adm; No Sep Date 063 Prior Not Discharged 065 Original Deleted Upd Sep < Cutoff 066 Sep Date Prior to Cutoff Date 101 Invalid Sep Date 102 Sep Date < Adm Date 108 Field(s) are missing From Sep 112 Calc Los +Leave Not = Adm/Sep 115 Adm Time Not < Sep Time 119 Sep Time - No Sep Date 122 Sameday Adm Source/ Sep Mode Mismatch 127 Nil Value DRG 160 AR-DRG Grouper GST Code > Code 179 Trans Sep Not Same As Episode 193 Not Separated – Intent Readmit 196 X4 Record Epis. Not Separated 258 Sub – Acute: No Sub Acute Record 259 Invalid Rehab/Subac – Episode Sep Date 265 Mental Health Status - Not Separated


322 ICU/CCU Stay > Total Stay 323 MV Duration > Total Stay 352 Code Not Found On Code File 388 Sep Referral - Episode Not Separated 401 Accom Type On Sep – Emerg, Not Same Day 421 Not Separated; Carer Avail Present 424 Not Separated: Fund Arr S/Be Spaces 438 NIV Duration >Total Stay 461 ACAS Status not Required 465 Adm Duration < 15 Mins 467 Adm Wt <1000g, LOS <28 Days, Sep Mode ≠ T or D 468 Care Type ≠ 1 or F, LOS >365 Days 474 Care Type E, LOS > 35 Days 504 Stat Episode: Next Episode > 1 Minute Apart 505 Stat Episode: Previous Episode > 1 Minute Apart 533 ACAS Status Code Required 549 Type B Crit for Adm, LOS >1 550 Type C Crit for Adm, LOS >1 551 Type C Crit for Adm, LOS >4 hrs 552 Type E Crit for Adm, LOS >1 553 Type E Crit for Adm, LOS <4 hrs 593 Invalid Sep Date; > Header 596 Same Day ECT: Not in Care Type 4 598 Same Day Rehabilitation: Not in Scope

Related items

Section 2: Length of Stay, Overnight or Multi-day Stay Patient, and Same Day Patient. Section 4: Business Rules (non-tabular) Length of Stay.

Administration Purpose To enable validation of patient days and to enable an episode of care to be

placed into month and year of separation: • For counting purposes. • To check codes in the record against the valid codes for that year.





Separation Mode

Specification Definition Status at separation of the person, and place to which the person is released

(where applicable).

Data type

Alpha Form Code

Field size

1 Layout A

Location

Episode Record





Code Descriptor

S Statistical Separation (change in Care Type within this hospital) D Death Z Left against medical advice T Separation and transfer to other acute hospital/extended

care/rehabilitation/geriatric centre R Separation and transfer to Restorative Care bed-based program B Separation and transfer to Transition Care bed based program A Separation and transfer to mental health residential facility N Separation and transfer to aged care residential facility H Separation to private residence/accommodation

Reporting guide S Statistical Separation (change in Care Type within this hospital)

Assign this code when a new episode of care (change in Care Type) occurs within the same hospital stay.

It is not permissible to: • Change to Alcohol and Drug Program Care Type following another episode of

care (for public hospitals). • Change between Rehabilitation Program/Units: Levels 1, 2 or 3 Care Types

(2, 6 or 7). • Change from or to Unqualified newborn (Care Type U) as a Statistical

Separation or a Statistical Admission. Changes between Qualified and Unqualified status of newborns are recorded in Status Segments using the Qualification Status field. Refer to Section 2: Newborns.

D Death

Died in hospital.


Z Left against medical advice Patient absconds or leaves against medical advice, at own risk. This Separation Mode is significant in the allocation of some DRGs. Includes: Newborns taken from the hospital against medical advice.

T Separation and transfer to other acute hospital/extended care/rehabilitation/ geriatric centre Separation and transfer to another hospital, regardless of whether the patient is to be admitted at the receiving hospital. Requires a Transfer Destination code. Includes: Unqualified newborn being transferred to another hospital. Public and private acute, extended care and mental health admitted patient units. Excludes: Restorative Care bed based program (use code R) Transition Care bed based program (use code B). Aged care residential facilities (use code N). Mental health residential units (use code A).

R Separation and transfer to Restorative Care bed based program Separation and transfer directly to a Restorative Care bed based program. Does not require a Transfer Destination code.

B Separation and transfer to Transition Care bed based program Separation and transfer directly to a Transition Care bed based program. Does not require a Transfer Destination code. Excludes: Home-based Transition Care (use code H and Separation Referral Code T).

A Separation and transfer to mental health residential facility Separation and transfer to mental health residential facility (includes psychogeriatric nursing home and community care unit) funded by Mental Health Services. Does not require a Transfer Destination code. Includes: Patient returning to the mental health residential facility in which they live. Mental health aged care residential facility. Excludes: Mental health admitted patient units (use code T).

N Separation and transfer to aged care residential facility Separation and transfer to an aged care residential facility (includes nursing home and hostel). Does not require a Transfer Destination code. Includes: Patient returning to the aged care residential facility in which they live. Excludes: Restorative Care bed based program (use code R). Transition Care bed based program (use code B). Mental health aged care residential facility (use code A).


H Separation to private residence/accommodation Place of residence immediately following separation. Requires a Separation Referral code. Includes: • Home or home of relative or friend. • Supported residential facilities. • Special accommodation houses. • Training centres for intellectually disabled persons. • Prison. • Forensic hospital (Thomas Embling) • Juvenile detention centre. • Armed forces base camp. • Homeless (shelters, half way houses). • A patient in Accommodation Type 4 in the Home (Hospital – HITH) in private

accommodation or residential facility who, on separation, remains in the same private accommodation.

• Home-based Transition Care. Excludes:

• Restorative Care bed based program (use code R). • Transition Care bed based program (use code B). • Aged care residential facility (use code N). • Mental health residential facility (use code A).


Edits 103 Invalid Sep Mode 108 Fields(s) Missing From Sep 109 Trans Dest Not Blank 110 Invalid Transfer Type 122 Sameday Adm Source/ Sep Mode Mismatch 127 Nil Value DRG 160 AR-DRG Grouper GST Code Zero 192 Invalid Comb Int. Readmit Sep Mode 288 Sep Barthel & Sep Mode Incompatible 291 Adm Barthel > Sep Barthel 297 Sep Rug ADL & Sep Mode Incompatible 328 Early Parenting Centre – Invalid Comb 329 Geri Respite – Invalid Comb 334 Hosp Generated DRG Not = PRS/2 DRG 390 Incompat Care Type, Carer Avail, Age and Sep Mode 394 Sep Mode Home, No Sep Referral 395 Sep Mode Not Home, Sep Referral Present 397 Sep Referral Postnatal, Incompat Age/Sex 423 Invalid Comb Fund/ Contract /Transfer 454 Incompat Fields for Interim Care 467 Adm Wt <1000g, LOS < 28 Days, Sep Mode ≠ T or D 471 Care Type 5x, not usual Sep Referral 489 Incompat Care Type/Sep Mode Statistical 493 Incompat Sep Mode/Age <15 494 Incompat Sep Mode/Age <55 501 Stat Episode: Adm Source ≠ Sep Mode Prev Episode 502 Stat Episode: Care Type same as Next Episode 504 Stat Episode: Next Episode > 1 Minute Apart 506 Stat Episode: Rehab also in Next Episode 509 Stat Episode: Sep Mode ≠ Adm Source Next Episode 510 Stat Sep Mode: No Subsequent Episode 597 Mental Health Episode: Sep Mode = S 642 Unqualified Newborn but Separation Mode D 643 Maternity Episode but Separation Mode D

Related items

Section 2: Admission, Admitted Patient, Episode of Admitted Patient Care, Geriatric Evaluation and Management Program, Hospital Stay, Interim Care, Nursing Home Type/Non-Acute care, Palliative Care, Rehabilitation Care and Transfer.

Section 3: Data Definitions, Transfer Source

Section 4: Business Rules (non-tabular) Episode of Care and Transfer Reporting

Section 4: Business Rules (tabular) Account Class: Geriatric Respite, and

Care Type: Designated and Separation Mode, Carer Availability and Separation Mode, Contracting: Funding Arrangement, Contract Type and Contract Role with Admission Source and Separation Mode, Criterion for Admission: Secondary Family Member and Intention to Readmit and Separation Mode.



• Distinguish between formal and statistical separations. • Study service patterns - Care Type changes, transfers. • Assist in the allocation of DRGs.




DH

Mapping between Separation Mode and the Grouper Mode of Separation: Separation Mode (PRS/2) Mode of Separation (NHDD and Grouper)

D Death 8 Died Z Left against medical advice 6 Left against medical advice T Separation and transfer to other acute hospital/

extended care/rehabilitation/geriatric centre 1 Discharge/transfer to an(other) acute

hospital R Separation and transfer to Restorative Care bed

based program 4 Discharge/transfer to other health care

accommodation B Separation and transfer to Transition Care bed

based program 4 Discharge/transfer to other health care

accommodation N Separation and transfer to aged care residential

facility 2 Discharge/transfer to a Residential Aged

Care Service A Separation and transfer to mental health

residential facility 4 Discharge/transfer to other health care

accommodation H Separation to private residence/accommodation 9 Other (includes to usual residence) S Statistical separation (change in Care Type within

this hospital) 5 Statistical discharge-type change


Separation Referral

Specification Definition Clinical care and support services arranged by the hospital to meet the person’s

recuperative needs when discharged to private accommodation or home.

Data type

Alpha Form Code

Field size

4 Layout AAAA or spaces Left justified, trailing spaces.

Location

Episode Record

Reported by Public hospitals. Private hospitals – Optional. If the private hospital chooses not to report these data, report spaces in this field.

Reported for Episodes where the Separation Mode is H Separation to private residence/accommodation. For all other Separation Modes, report spaces in this field.


Code set Select up to four options from list. Do not repeat codes. If more than four referrals have been made, select the first four listed:

Code Descriptor

F Domiciliary postnatal care, arranged before discharge P Post Acute Care Program services, arranged before discharge M Referral to a community rehabilitation centre arranged before

discharge L Alcohol and drug treatment service, arranged before discharge B Community palliative care support, arranged before discharge U Home nursing support, arranged before discharge C Mental health community services, arranged before discharge S Referral to private psychiatrist, arranged before discharge D Psychiatric disability support services, arranged before discharge G Referral to general practitioner, arranged before discharge A Referral to Aged Care Assessment Service (ACAS), arranged before

discharge K Referral to Aboriginal and Torres Strait Islander (ATSI) service,

arranged before discharge T Referral to Transition Care home based program, arranged before

discharge R Other clinical care and/or support services, arranged before discharge X No referral or support services arranged before discharge

Reporting guide In arranging the referral of a patient to these services, the hospital would expect

to receive confirmation from the referred provider of their preparedness to accept responsibility for delivering the required services to the patient upon discharge.

Unless a specific service has been arranged, use code X No referral or support


services arranged before discharge.

F Domiciliary postnatal care, arranged before discharge

Mother discharged, with domiciliary postnatal care arranged before discharge to her own home or home of relative or friend or other private accommodation*. Domiciliary care includes that provided by the hospital and by home nursing services. Code not for use for the baby’s Separation Mode: unless a specific service (with another code) has been arranged for the baby, baby’s code would be X No referral or support services arranged before discharge.

P Post Acute Care Program services, arranged before discharge

Discharge, with provision of Post Acute Care Program services arranged before discharge to own home or home of relative or friend or other private accommodation*. For more information about Post Acute Program Services refer to Victorian health policy and funding guidelines 2011-2012 available at: http://www.health.vic.gov.au/pfg/

M Referral to a community rehabilitation centre arranged before discharge

Discharge, with referral to community rehabilitation centre (formerly known as day hospital) arranged before discharge to own home or home of relative or friend or other private accommodation*. Excludes: Discharge, with referral to alcohol and drug treatment service (use code L).

L Referral to alcohol and drug treatment service, arranged before discharge

Discharge, with referral to alcohol and drug treatment service, arranged before discharge to own home or home of relative or friend or other private accommodation*.

B Community palliative care support, arranged before discharge

Discharge, with community palliative care service support arranged before discharge to own home or home of relative or friend or other private accommodation*.

U Home nursing support, arranged before discharge

Discharge, with home nursing support arranged before discharge to own home or home of relative or friend or other private accommodation*. Home nursing support includes that provided by the hospital and by district nursing services.

C Mental health community services, arranged before discharge

Discharge, with mental health community services arranged before discharge to own home or home of relative or friend or other private accommodation*.


http://www.health.vic.gov.au/pfg/

S Referral to private psychiatrist, arranged before discharge

Discharge, with referral to a private psychiatrist arranged before discharge to own home or home of relative or friend or other private accommodation*.

D Psychiatric disability support services, arranged before discharge

Discharge, with referral to psychiatric disability support services arranged before discharge to own home or home of relative or friend or other private accommodation*.

G Referral to general practitioner, arranged before discharge

Discharge, with referral to general practitioner arranged before discharge to own home or home of relative or friend or other private accommodation*.

A Referral to Aged Care Assessment Service (ACAS), arranged before discharge

Discharge, with referral to Aged Care Assessment Service (ACAS) arranged before discharge to own home or home of a relative or friend or other private accommodation.

K Referral to Aboriginal and Torres Strait Islander (ATSI) service, arranged before discharge

Discharge, with referral to an Aboriginal and Torres Strait Islander (ATSI) service arranged before discharge to own home or home of a relative or friend or other private accommodation*. Includes: Services provided by the local Aboriginal co-operative Designated Koori HACC services Designated Koori Alcohol and Drug Services

T Referral to Transition Care home based program, arranged before discharge

Discharge, with referral to a Transition Care home based program arranged before discharge to own home or home of a relative or friend or other private accommodation*. Excludes: Bed-based Transition Care (use Separation Mode code B).

R Other clinical care and/or support services, arranged before discharge

Discharge, with other clinical care and support service arranged before discharge to own home or home of relative or friend or other private accommodation*. Includes: • Discharge to residential care facility if patient was admitted from a less

supportive form of accommodation, such as a private home. • Discharge of newborn to foster care. • Any service not under the other values for this field (for example, outpatient

appointment, specialist appointment, meals on wheels, home maintenance services, private community care and services, community health services, private allied health services, maternal and child health services).


X No referral or support services arranged before discharge

No referral or support services arranged before discharge to own home or home of relative or friend or other private accommodation*.

Notes:

*Private accommodation comprises: Supported residential facilities, special accommodation houses, half-way houses, training centres for intellectually disabled persons, prisons, and armed forces hospitals. Includes: • A patient treated under the HITH program in private accommodation or

residential facility who, on separation, remains in the same private accommodation.

• A newborn discharged with his/her mother.

Edits 329 Geri Respite – Invalid Comb 388 Sep Referral - Episode Not Separated 389 Invalid Sep Referral 394 Sep Mode Home, No Sep Referral 395 Sep Mode not Home, Sep Referral Present 396 Sep Referral, No Refer Plus Other Ref 397 Sep Referral Postnatal, Incompatible Age/ Sex 398 Sep Referral, Duplicates 454 Incompat Fields for Interim Care 462 Incompat ACAS Status and Sep Referral 471 Care Type 5x, not usual Sep Referral 495 Incompat Sep Referral and Indigenous Status

Related items

Section 3: Separation Mode. Section 4: Business Rules (tabular) Account Class: Geriatric Respite and Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).

Administration Purpose To monitor discharge planning processes to inform policy and planning.

Principal data users Continuing Care and Clinical Service Development (Hospital & Health Service

Performance, DH).

Collection start 1999-00 (Formerly a sub-set of Separation Mode)


DH


Separation Time

Specification Definition The time at which a patient completes an episode of care.

Data type

Numeric Form Time

Field size

4 Layout HHMM

Location

Episode Record




Code set A valid 24-hour time (not 0000 or 2400).

Reporting guide For a formal separation, the Separation Time is the time at which patient presents at the discharge office/desk. For patients who leave against medical advice, Separation Time is the time of last patient contact. For patients who die in hospital, Separation Time is the time of death (that is, brain death).

For a statistical separation, (Care Type change), a dummy Separation Time is acceptable to enable the times to be automatically recorded. Care Type changes could be recorded as occurring at midday. The Separation Time must be one minute earlier than the Admission Time of the following episode (for example, if Separation Time of the earlier episode was made to be 1200, Admission Time of the new episode would be 1201).

Midnight

Following international convention, midnight is either 2359 of preceding date or 0001 of following date (0000 and 2400 are not accepted).

Edits 027 Adm Record; Overlap Existing 108 Fields(s) Missing From Sep 114 Invalid Sep Time 115 Adm Time Not < Sep Time 119 Sep Time - No Sep Date 322 ICU/CCU Stay > Total Stay 323 MV Duration > Total Stay 438 NIV Duration > Total Stay 465 Adm Duration < 15 Mins 504 Stat Episode: Next Episode > 1 Minute Apart 505 Stat Episode: Previous Episode > 1 Minute Apart 551 Type C Crit for Adm, LOS >4 hrs 553 Type E Crit for Adm, LOS <4 hrs

Related items

Section 2: Time of Death.


Administration Purpose To enable the exact Length of Stay to be determined.



Collection start

1993-94



Sex…………

Specification Definition The sex of the person.

Data type

Numeric Form Code

Field size

1 Layout N

Location

Episode Record





1 Male 2 Female 3 Indeterminate 4

Intersex

Reporting guide Sex should be inferred or accepted as reported by the respondent, as at the time of the admission. That is, it is usually unnecessary and may be inappropriate or even offensive to ask a person their sex. Sex may be inferred from other cues such as observation, relationship to respondent, or first name. A person’s sex may change during their lifetime as a result of procedures known alternatively as Sex change, Gender reassignment, Transsexual surgery, Transgender reassignment or Sexual reassignment. Throughout this process, which may be over a considerable period of time, sex could be recorded as either Male or Female. In data collections that use the ICD-10-AM classification, where sex change is the reason for admission, diagnoses should include the appropriate ICD-10-AM code(s) that clearly identify that the person is undergoing such a process. This code(s) would also be applicable after the person has completed such a process, if they have a procedure involving an organ(s) specific to their previous sex (for example, where the patient has prostate or ovarian cancer). The term ‘intersex’ refers to a person, who, because of a genetic condition was born with reproductive organs or sex chromosomes that are not exclusively male or female and who identifies as being neither male nor female. Excludes: transgender, transsexual and chromosomally indeterminate individuals who identify with a particular sex (male or female).

Code 3 Indeterminate should be used for infants with ambiguous genitalia, where the biological sex, even following genetic testing, cannot be determined. Code 3 can only be assigned for infants aged less than 90 days.


Codes 3 Indeterminate and 4 Intersex should not generally be used on data collection forms completed by the respondent. They should only be used if the person or respondent volunteers that the person is intersexual or where it becomes clear during the collection process that the individual is neither male nor female.

Edits 033 Invalid Sex 059 Maternity - Not Female 080 Sex Indeterminate, age < 90 days 127 Nil Value DRG 160 AR-DRG Grouper GST Code>Zero 215 Sex Indeterminate But Age>= 90 days 354 Code & Sex Incompatible 397 Sep Referral Postnatal, Incompat Age/Sex 450 Code Incompatible W Female Sex 451 Code Incompat W Male Sex 580 MHSWPI Valid, no Matching Sex 585 Sex Code Intersexual

Related items

Section 2: Age and DRG Classification.

Administration Purpose To enable:

• Analyses of service utilisation, need for services and epidemiological studies. • Verification of other fields (such as diagnosis and procedure codes) for

consistency. • To assist in the allocation of DRGs.



Collection start

1979-80

Definition source ABS Code set source

NHDD (DH modified).


Source of Referral to Palliative Care

Specification Definition The source of the person’s referral to the DH Palliative Care Program.

Data type

Numeric Form Code

Field size

2 Layout NN Right justified, leading zero.

Location

Sub-Acute Record


Reported for Episodes with Care Type 8. For Care Types P, 2, 6, 7, K, 9, F or E, report spaces.



Code Descriptor

01 Community Sector - GP 02 Community Sector - Specialist 03 Community Sector - Self, Carer, Other (eg family member, neighbour) 04 Community Sector - Community Based Agency 05 Hospital - Public - Admitted patient 06 Hospital - Private - Admitted patient 07 Hospital - Outpatient - Non-admitted patient 08 Residential Care - Nursing Home/Hostel 09 Other

Reporting guide -

Edits 258 Sub-Acute: No Sub-Acute Record

340 Invalid Source Of Refer to Pal Care 341 Source Of Refer to Pal Care Present 454 Incompat Fields for Interim Care

Related items

Section 2: Palliative Care. Section 4: Business Rules (tabular) Care Type: Designated and Non-Designated Rehabilitation Programs (2, 6, 7 and K), and Care Type P: Designated Paediatric Rehabilitation Program, and Care Type: Interim Care Program (F and E).

Administration Purpose To inform policy and planning decisions.

Principal data users Cancer and Palliative Care Unit (Hospital & Health Service Performance, DH).



DH


Surname

Specification Definition The surname of the DVA or TAC patient.

Data type


Field size

25 Layout AXXXXXXXXXXXXXXXXXXXXXXXX

Location

DVA and TAC Record


Reported for Admitted episodes with an Account Class of V- DVA or T- TAC.


Reporting guide Surname of the person. Permitted characters: A to Z (uppercase), space, apostrophe, and hyphen. The first character must be an alpha character.

Edits 161 Invalid Surname 557 Surname Unusual Length

Related items

Section 3: Account Class and Given Name(s).

Administration Purpose To facilitate payment by DVA and TAC for relevant episodes of care.


Principal data users Department of Veteran’s Affairs and Transport Accident Commission.

Collection start

1992-93


-


Transfer Destination

Specification Definition Identification of the hospital campus to which a person is transferred, following

separation from this hospital campus. Data type Numeric Form Code

Field size 4 Layout NNNN or spaces



Reported for Admitted episodes where the Separation Mode is T Separation and transfer to other acute hospital/extended care/rehabilitation/geriatric centres. Otherwise, report spaces.


Code set Refer to the Hospital Code Table reference file available from: http://www.health.vic.gov.au/hdss/reffiles/index.htm

Hospital identifier for interstate and overseas hospitals Compile a code according to the following convention:

First character: 9 for all interstate and overseas hospitals

Second character: state/overseas identifier 0 Queensland 1 New South Wales 2 Tasmania 3 South Australia 4 Western Australia 5 ACT 6 Northern Territory 7 New Zealand 8 Other overseas Third character: hospital type 0 Major specialist/teaching 1 Other public acute 2 Extended care 3 Private 5 Psychiatric (public only) 6 Rehabilitation (public only) 9 Other healthcare accommodation (eg early parenting centres) Fourth character: 7 for all interstate and overseas hospitals Thus, an extended care hospital in New South Wales would be coded 9127. Unknown Transfer Destination code is 9999

Reporting guide Forensic Hospitals and Armed Forces Hospitals

These are not generally recognised as hospitals by the Australian Government Department of Health and Ageing, and therefore separation to such facilities is not an inter-hospital transfer (use Separation Mode H Separation to private



accommodation or home).

Edits 078 T- Srce T- Dest Code Matches Hosp

109 Transfer Dest Not Blank 110 Invalid Transfer Type

Related items

Section 2: Transfer.

Section 4: Business Rules (non-tabular) Transfer Reporting.

Refer to the Hospital Code Table reference file available from:


Administration Purpose Study of transfer patterns.

Principal data users Health Policy Analysis and Reporting (Hospital & Health Service Performance,

DH).



DH



Transfer Source

Specification Definition Identification of the hospital campus the person has been transferred from,

following separation from that hospital. Data type

Numeric Form Code

Field size

4 Layout NNNN or spaces

Location

Episode Record


Reported for Admitted episodes where the Admission Source is T Transfer from acute hospital/extended care/rehabilitation/geriatric centres.



Code set Refer to the Hospital Code Table reference file available from: http://www.health.vic.gov.au/hdss/reffiles/index.htm

Hospital identifier for interstate and overseas hospitals Compile a code according to the following convention: First character: 9 for all interstate and overseas hospitals

Second character: state/overseas identifier 0 Queensland 1 New South Wales 2 Tasmania 3 South Australia 4 Western Australia 5 ACT 6 Northern Territory 7 New Zealand 8 Other overseas Third character: hospital type 0 Major specialist/teaching 1 Other public acute 2 Extended care 3 Private 5 Psychiatric (public only) 6 Rehabilitation (public only) 9 Other healthcare accommodation (eg early parenting centres) Fourth character: 7 for all interstate and overseas hospitals Thus, an extended care hospital in New South Wales would be coded 9127.

Unknown Transfer Source code is 9999




Reporting guide Forensic Hospitals and Armed Forces Hospitals

These are not generally recognised as hospitals by the Australian Government Department of Health and Ageing, and therefore admission from such facilities is not an inter-hospital transfer (use Admission Source Z Other formal admission source).

Edits 042 Invalid Transfer Source

051 Transfer Source Not Blank 078 T- Srce/ T- Dest Code Matches Hosp 329 Geri Respite – Invalid Comb

Related items

Section 2: Transfer. Section 4: • Business Rules (non-tabular) Transfer Reporting. • Business Rules (tabular) Account Class: Geriatric Respite Refer to the Hospital Code Table reference file available from:


Administration Purpose Study of transfer patterns.

Principal data users Health Policy Analysis and Reporting (Hospital & Health Service Performance,

DH).



DH



Unique Key

Specification Definition A unique identifier specific to an individual admitted patient episode of care.

Data type


Field size

9 Layout XXXXXXXXX Right justified, zero filled.

Location

Episode Record Diagnosis Record Extra Diagnosis Record Sub-Acute Record DVA and TAC Record



Reported when Any of the above record types is reported.

Code set Hospital-generated.

Reporting guide The Unique Key can be computer-generated or have specific relevance at the hospital.

A Unique Key should not be changed. If in exceptional circumstances there is a need to alter the number (eg miss-punched) the original episode would have to be deleted and re-submitted with a new Unique Key.

Do not re-use a Unique Key; a Unique Key must not be re-assigned to another episode for the same patient or to another patient. When changing software supplier, care must be taken to ensure Unique Keys remain unique, i.e. new episodes should be allocated a number higher than the last number reported.

Edits 005 Deletion Record - No Match Found

026 Zero Sep; Existing Not Discharged 027 Adm Record; Overlaps Existing 028 Prior Adm; No Sep Date 060 Unique Key Blank 062 Duplicate Pt ID, Adm Date Time, Diff Unique 063 Prior Not Discharged 064 Duplicate Pt ID, Date Time 169 No Corresponding Episode 192 Diagnoses Delete: No Record On File 248 Tran Pt ID Not Same As Episode Or Subac 249 No Sub-Acute to Delete 259 Invalid Rehab/Subac- Episode Sep Date 371 Episode Deletion: DVA/TAC Trans Present 372 Episode Deletion: Multiple Epis Trans 374 Episode DVA/TAC V4 Transaction 375 Episode DVA/TAC: V4 Trans Rejected 377 Episode DVA/TAC: Multiple E4 Trans



378 Episode DVA/TAC: Multiple V4 Trans 379 Epis Not DVA/TAC: V4 Trans Present 380 Epis Not DVA/TAC: V4 Trans: Multiple E4s 382 Epis Not DVA/TAC: Multiple V4 Trans 383 V4 Trans: No Episode Trans 384 V4 Trans: Multiple Episode Trans 531 Same UK, diff Pt ID

Related items

-

Administration Purpose To enable data records (E4, X4, Y4, S4, and V4) to be amalgamated into a

single record for each episode of care, for editing and reporting purposes.



Collection start

1990-91


Hospital-generated.

Documents

Section 3 – Data definitions · Section 3 – Data definitions, VAED Manual, 21st Edition, July 2011 Page iii . Functional Assessment Date on Separation (b) 96 ... Alpha/numeric